Individual provider Active NPI

Sungmin Alex Jung Jodis

  • Acupuncturist
  • Rochester Hills, MI
National Provider Identifier
1972233831
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
U02755 Issued in MD
Practice address
1655 S Shore Dr
Rochester Hills, MI 48307-4342
Phone
(248) 270-8266
NPI assigned
Jun 14, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X U02755 MD Primary

Addresses

Primary practice location

1655 S Shore Dr
Rochester Hills, MI 48307-4342

Mailing address

52575 Blueridge Dr
Shelby Township, MI 48316-2937
Phone (248) 270-8266

Other practice location 1

5411 W Cedar Ln Ste 108A
Bethesda, MD 20814-1516
Phone (240) 483-0161

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
U02755MDMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Join Acupuncture and Herbal Medicine in Mi Acupuncturist CurrentSince Feb 18, 2024 Accepting new patients
Total Health Systems Inc Past Accepting new patients
Join Acupuncture & Herbal Medicine Acupuncturist Past Accepting new patients

Locations

2032 E Square Lake Rd
Ste 400
Troy, MI 48085
Phone (248) 270-8266

2032 E Square Lake Rd
Troy, MI 48085
Phone (248) 672-8112

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": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1972233831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52575 BLUERIDGE DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483162937",
            "telephone_number": "248-270-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 S SHORE DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483074342",
            "telephone_number": "248-270-8266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5411 W Cedar Ln Ste 108A",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208141516",
            "country_code": "US",
            "telephone_number": "240-483-0161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUNG JODIS",
        "first_name": "SUNGMIN ALEX",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MD",
            "license": "U02755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.

Verify at the official NPI Registry.