Active NPI
Jeong Eun Oh, MD
- Family Medicine Physician
- Westbrook, CT
National Provider Identifier
1972780930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 046567
- Practice address
- 4 Grove Beach Rd N
Bldg1, Unit a
Westbrook, CT 06498-1656 - Phone
- (860) 664-3553
- Fax
- (860) 358-8656
- NPI assigned
- Jan 22, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 046567 | CT | Primary |
Addresses
Primary practice location
4 Grove Beach Rd N
Bldg1, Unit a
Westbrook, CT 06498-1656
Mailing address
28 Crescent St
Middletown, CT 06457-3654
Phone (860) 358-4820
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008001633 | Medicaid | CT |
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 |
|---|---|---|---|
| 046567 | CT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MHS Primary Care Inc | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
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": "1200960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336089600000",
"number": "1972780930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 CRESCENT ST",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064573654",
"telephone_number": "860-358-4820",
"fax_number": "860-358-6748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 GROVE BEACH RD N",
"address_2": "BLDG1, UNIT A",
"city": "WESTBROOK",
"state": "CT",
"postal_code": "064981656",
"telephone_number": "860-664-3553",
"fax_number": "860-358-8656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OH",
"first_name": "JEONG",
"middle_name": "EUN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-22",
"last_updated": "2012-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CT",
"license": "046567",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008001633",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Westbrook, CT
- Middlesex Orthopedic Surgeons,P.C.
- Ellen Marie Morris-White, MSN, RN, FNP-C
- Kelly Keefe Nelson, MD
- Lauren Hart Nichols, PA-C
- Andrea Marie Niziolek, PA
- Orthopaedic & Neurosurgery Specialists, PLLC
- Orthopaedic & Neurosurgery Specialists, PLLC
- Orthopedic Associates of Middletown, PC
- Melissa Ortiz-Sinclair, MS, LPC
- Jodi Marak Ouellette, ATC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.