Individual provider Active NPI

Sungmin Hong, DC

  • Chiropractor
  • Lees Summit, MO
National Provider Identifier
1972015360
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2017032088 Issued in MO
Practice address
731 NE Lakewood Blvd
Lees Summit, MO 64064-1353
Phone
(816) 373-3373
NPI assigned
Oct 25, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X MO
Chiropractor 111N00000X 2017032088 MO Primary

Addresses

Primary practice location

731 NE Lakewood Blvd
Lees Summit, MO 64064-1353

Mailing address

12308 Crystal Ave
Grandview, MO 64030-2083
Phone (314) 914-2696

Other identifiers 1

IdentifierTypeStateIssuer
230106425MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210910002830 MO Practitioner - Chiropractic 5294131546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakewood Chiropractic, PCGroup PAC ID 7719920677, 4 clinicians

Practice addresses (Care Compare)

731 NE Lakewood Blvd
Lees Summit, MO 64064-1353
Phone (816) 373-3373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Chiropractic P.C. Chiropractor CurrentSince Aug 1, 2021 Accepting new patients
Lohan Chiropractic and Acupuncture Clinic LLC Chiropractor PastSince Jul 19, 2012 Accepting new patients
Lakewood Chiropractic, P.C. Chiropractor PastSince Aug 1, 2021 Accepting new patients

Locations

731 N E Lakewood Blvd
Lees Summit, MO 64064
Phone (816) 373-3373

731 NE Lakewood Blvd
Lees Summit, MO 64064
Phone (816) 373-3373

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1972015360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12308 CRYSTAL AVE",
            "city": "GRANDVIEW",
            "state": "MO",
            "postal_code": "640302083",
            "telephone_number": "314-914-2696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 NE LAKEWOOD BLVD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640641353",
            "telephone_number": "816-373-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HONG",
        "first_name": "SUNGMIN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-25",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2017032088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230106425",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.