MR. SHANE OLIVER CHUNG (NPI# 1336377688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336377688 |
| Entity Type | Individual |
| Full Name | MR. SHANE OLIVER CHUNG |
| Credential | SFIDC |
| Practice Address |
302 Warren Street Apt 3 Norfolk VA 23505 |
| Practice Telephone | 9146123554 |
| Mailing Telephone | 9146123554 |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2009-06-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| Street Address |
302 WARREN STREET APT 3 |
| City | NORFOLK |
| State | VA |
| Zip Code | 23505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154844256 | Cassandra Shelton | Specialist/Technologist, Other | 100 Kingsley Lane, Norfolk, VA 23505 | 2017-07-20 |
| 1063942852 | Gabriela Marie Santiago | Specialist/Technologist | 7600 Victory Dr, Apt 3, Norfolk, VA 23505 | 2017-06-14 |
| 1144776725 | Amr Hassan | Pharmacist | 1610 W Little Creek Rd, Apt 204, Norfolk, VA 23505 | 2016-09-01 |
| 1992175095 | Heather Mitchell | Nurse Practitioner | 110 Kingsley Ln Ste 309, Norfolk, VA 23505 | 2015-10-01 |
| 1255710620 | Jessica Ann Kestranek | Dentist | 7400 Granby St Ste D, Norfolk, VA 23505 | 2015-05-19 |
| 1710375274 | Carla Toledo | Nurse Practitioner | 155 Kingsley Lane, Suite 400, Norfolk, VA 23505 | 2015-01-06 |
| 1417359746 | James Austin Valone Jr. | Ophthalmology | 1423 Runymede Rd, Norfolk, VA 23505 | 2014-09-18 |
| 1861813370 | Harris Teeter, LLC | Pharmacy | 7550 Granby Street, Norfolk, VA 23505 | 2013-12-31 |
| 1649549361 | Linda Horsey | Social Worker | 7510 Granby Street, Suite 6, Norfolk, VA 23505 | 2011-12-27 |
| 1679705164 | Carolyn Lee Kee | Nurse's Aide | 7403 Hampton Blvd, Norfolk, VA 23505 | 2009-08-17 |
| Find all providers in zip 23505 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447814090 | Francis Anthony Edquid | Military Health Care Provider | 9560 Farragut Ave, Norfolk, VA 23511-2715 | 2019-04-30 |
| 1215591888 | Nash Richard Galvan | Military Health Care Provider | 456-462 Pocahontas St, Norfolk, VA 23511 | 2019-04-29 |
| 1841694684 | Andre Huggins | Military Health Care Provider | 1687 Pocahontas St, Bldg 1a, Norfolk, VA 23511-2918 | 2014-10-21 |
| 1861753030 | Spencer Grey | Military Health Care Provider | 334 E Evans St, Norfolk, VA 23503-5213 | 2012-06-05 |
| 1508155375 | Leonard B Gordon | Military Health Care Provider | Comnavsurflant N02m, 1430 Mitscher Ave, Norfolk, VA 23551-2494 | 2011-04-01 |
| 1073812095 | Eric William Staley | Military Health Care Provider | 7958 Blandy Road, Commander Submarine Force Atlantic, Norfolk, VA 23551-2492 | 2011-03-16 |
| 1497051460 | Mitchell Todd Pearce | Military Health Care Provider | 1004 Hermitage Rd., Norfolk, VA 23521-5000 | 2011-02-08 |
| 1003119538 | Shayla R Robertson | Military Health Care Provider | 150 Allen St, Norfolk, VA 23505-1373 | 2010-12-05 |
| 1053629964 | Shawnly Heath Ward | Military Health Care Provider | Surface Warfare Medical Institute - East, 459 Bellinger Blvd, Norfolk, VA 23511 | 2010-09-14 |
| 1225351760 | Jocelyn Martinezdelgado | Military Health Care Provider | 8857 1st Street, Pcu Jason Dunham Suite 400, Norfolk, VA 23511 | 2010-03-11 |
| Find all providers in NORFOLK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.