Active NPI
Thomas S. Chung, M.D.
- Radiation Oncology Physician
- Saint Louis, MO
National Provider Identifier
1962473751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- 2013012262
- Practice address
- 915 N Grand Blvd
Saint Louis, MO 63106-1621 - Phone
- (314) 289-6324
- Fax
- (314) 289-6322
- NPI assigned
- Jan 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | 036-104163 | IL | |
| Radiation Oncology Physician | 2085R0001X | A78262 | CA | |
| Radiation Oncology Physician | 2085R0001X | 01067637A | IN | |
| Radiation Oncology Physician | 2085R0001X | 2013012262 | MO | Primary |
Addresses
Primary practice location
915 N Grand Blvd
Saint Louis, MO 63106-1621
Mailing address
PO Box 955534
Saint Louis, MO 63195-5534
Other practice location 1
1011 Bowles Ave Ste G50
Fenton, MO 63026-0562
Phone (636) 496-4640
Other practice location 2
1475 Kisker Road
Suite 190
St. Charles, MO 63304
Phone (636) 442-7370
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200969650 | Medicaid | IN | |
| 3008471 | Medicaid | OH |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tchung84881@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A78262 | CA | MD | Radiation Oncology Physician |
| 036-104163 | IL | MD | Radiation Oncology Physician |
| 01067637A | IN | MD | Radiation Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710115200000",
"number": "1962473751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 955534",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631955534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 N GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631061621",
"telephone_number": "314-289-6324",
"fax_number": "314-289-6322"
}
],
"practiceLocations": [
{
"address_1": "1011 Bowles Ave Ste G50",
"address_purpose": "LOCATION",
"city": "Fenton",
"state": "MO",
"postal_code": "630260562",
"country_code": "US",
"telephone_number": "636-496-4640",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1475 Kisker Road",
"address_2": "Suite 190",
"address_purpose": "LOCATION",
"city": "St. Charles",
"state": "MO",
"postal_code": "63304",
"country_code": "US",
"telephone_number": "636-442-7370",
"fax_number": "636-442-7397",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHUNG",
"first_name": "THOMAS",
"middle_name": "S.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-30",
"last_updated": "2024-03-11",
"certification_date": "2024-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "IL",
"license": "036-104163",
"primary": false
},
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "CA",
"license": "A78262",
"primary": false
},
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "IN",
"license": "01067637A",
"primary": false
},
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "MO",
"license": "2013012262",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200969650",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3008471",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tchung84881@direct-ehr-ssmhc.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "tchung84881@direct-ehr-ssmhc.com",
"address_1": "1011 Bowles Ave Ste G50",
"city": "Fenton",
"state": "MO",
"country_code": "US",
"postal_code": "630260562",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "1011 Bowles Ave Ste G50",
"city": "Fenton",
"state": "MO",
"country_code": "US",
"postal_code": "630260562",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.