JC Clinic, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

JC CLINIC, LLC

Doing business as

OWR Clinic

Practice address

1295 Old Peachtree Rd NW Ste 270B
Suwanee, GA 30024-4970

Phone

(678) 770-6085

NPI assigned

Jul 6, 2023

Last updated

Sep 15, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

In Chung, APRN

Title

Owner

Phone

(678) 770-6085

Specialties & licenses 1

Addresses

Other names 1

• OWR Clinic Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694736000000",
    "number": "1962180406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1295 OLD PEACHTREE RD NW STE 270B",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244970",
            "telephone_number": "678-770-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 OLD PEACHTREE RD NW STE 270B",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244970",
            "telephone_number": "678-770-6085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JC CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-06",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "IN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-770-6085",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OWR Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OWR Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.