Hyeong Jun Ji, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

003710-1 Issued in NY

Practice address

1 Redmen St
Islip Terrace, NY 11752-2805

Phone

(646) 943-0027

NPI assigned

Mar 13, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Peter Ji Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1972062529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5160 VAN KLEECK ST APT 6N",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734216",
            "telephone_number": "646-943-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 REDMEN ST",
            "city": "ISLIP TERRACE",
            "state": "NY",
            "postal_code": "117522805",
            "telephone_number": "646-943-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JI",
        "first_name": "HYEONG JUN",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-13",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "003710-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PETER",
            "last_name": "JI",
            "credential": "ATC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lisa M Hoppe
• Lystra Huebner
• Barbara Jackson, RN
• Tracy James
• Navjot Jammu, RN
• John T Gordon D.D.S., P.C.
• Kathleen Johnson
• Leighann G Katos, LPN
• Heidi Keil, MS, OTR/L
• Samantha Keisari

• Athletic Trainer in Islip Terrace, NY
• Providers in Islip Terrace, NY by specialty
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; 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.