Jae Yeon Jeong, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

04731 Issued in MD

Practice address

10 N Greene Street
VA Maryland Health Care System
Baltimore, MD 21201-1524

Phone

(410) 605-7000

NPI assigned

Oct 5, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1254700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1982939195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 N GREENE STREET",
            "address_2": "VA MARYLAND HEALTH CARE SYSTEM",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011524",
            "telephone_number": "410-605-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N GREENE STREET",
            "address_2": "VA MARYLAND HEALTH CARE SYSTEM",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011524",
            "telephone_number": "410-605-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEONG",
        "first_name": "JAE YEON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-05",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "018728",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "04731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Fox Jensen, CRNP - F
• Jenifer Rae Brake Jenshoej, LGSW
• Jordan Jent
• Jenx Family Dentistry, L.L.C.
• Janice Yoonmi Jeon, M.D.
• Debbie C Jerez
• Kyle Patrick Jernigan, LGSW
• David Jerrard
• Jerry a Kilian'S Canton Dental Associates PA
• Jeradine Sabah Fatuma Jerry

• Psychologist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; 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.