Samuel Jaejin Chung, D.O.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

DO1217 Issued in TN

Practice address

2802 North Highland Avenue
Suite C
Jackson, TN 38305-1847

Phone

(731) 660-3530

Fax

(731) 660-3560

NPI assigned

Aug 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jackson Madison County General Hospital

  • General Practice Physician
  • Jackson, TN
  • NPI 1467493916

  Physical Medicine & Rehabilitation

  NPD (past)
• West Tennessee Rehab Group, P.C.

  • Physical Medicine & Rehabilitation Physician
  • Jackson, TN
  • NPI 1780675066

  Physical Medicine & Rehabilitation

  NPD (past)

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962510396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2802 NORTH HIGHLAND AVENUE",
            "address_2": "SUITE C",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051847",
            "telephone_number": "731-660-3530",
            "fax_number": "731-660-3560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2802 NORTH HIGHLAND AVENUE",
            "address_2": "SUITE C",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051847",
            "telephone_number": "731-660-3530",
            "fax_number": "731-660-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "SAMUEL",
        "middle_name": "JAEJIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TN",
            "license": "DO1217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christ Community Health Services, Inc.
• Christ Community Health Services, Inc.
• Christian L. Culbreath, DDS, Ms
• Kyle Ray Christianson, MD
• Nell H Christopherson
• Brandon Scott Churchill, MD
• Darla Cislaghi, CP, LP
• Megan Christine Clampitt, CRNA
• April Clanton, CLINICIAN
• Claritiv Health LLC

• All providers in Jackson, TN
• Physical Medicine & Rehabilitation Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.