JACQUELINE CHUNG (NPI# 1396033981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396033981 |
| Entity Type | Individual |
| Full Name | JACQUELINE CHUNG |
| Credential | MD |
| Practice Address |
1602 N 2nd St Clinton MO 64735-1192 |
| Practice Telephone | 6608858171 |
| Practice Fax Number | 6608908495 |
| Mailing Telephone | 6608858171 |
| Mailing Fax Number | 6608908495 |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2014-10-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 2014021724 | MO | Allopathic & Osteopathic Physicians |
| N | 281P00000X | Chronic Disease Hospital | 2011020643 | MO | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | MEDICARE PTAN | 787000018 | 01 |
| Street Address |
1602 N 2ND ST |
| City | CLINTON |
| State | MO |
| Zip Code | 64735-1192 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841288834 | Candice J. Baker | Nurse Practitioner | 1602 N 2nd St, Clinton, MO 64735-1192 | 2005-10-12 |
| 1760967533 | Heather Dains | Nurse Practitioner | 1602 N 2nd St, Clinton, MO 64735-1192 | 2018-09-27 |
| 1356820179 | Brenda Gale Messer | Nurse Practitioner | 1602 N 2nd St, Clinton, MO 64735-1192 | 2018-08-13 |
| 1043705080 | Taylor Marie Lincoln | Nurse Practitioner | 1602 N 2nd St, Clinton, MO 64735-1192 | 2018-06-22 |
| 1144767302 | Melondy Ann Bowland | Social Worker | 1602 N 2nd St, Clinton, MO 64735-1192 | 2017-01-26 |
| 1538605001 | Angela Heck | Social Worker | 1602 N 2nd St, Clinton, MO 64735 | 2017-01-09 |
| 1346694106 | Golden Valley Memorial Hospital District | Clinic/Center | 1602 N 2nd St, Clinton, MO 64735-1192 | 2016-04-19 |
| 1811357411 | Luke Schumacher | Physician Assistant | 1602 N 2nd St, Clinton, MO 64735-1192 | 2016-02-25 |
| 1528443264 | Renee Baker | Nurse Practitioner | 1602 N 2nd St, Clinton, MO 64735-1192 | 2015-07-23 |
| 1861875684 | Golden Valley Memorial Hospital | Nurse Practitioner | 1602 N 2nd St, Clinton, MO 64735-1192 | 2015-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730543778 | Courtney Briggs | Speech-Language Pathologist | 502 S. 5th, Clinton, MO 64735 | 2016-04-06 |
| 1447669924 | James Taylor Thatcher II | Counselor | 1800 Community Drive, Clinton, MO 64735 | 2014-08-08 |
| 1205271897 | Rocksheng Zhong | Psychiatry & Neurology | 1800 Community Dr, Clinton, MO 64735 | 2013-05-08 |
| 1407196272 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1501 E Ohio St, Clinton, MO 64735 | 2013-02-15 |
| 1265614176 | Kristal Lynn Moran | Registered Nurse | 1600 N Second St, Clinton, MO 64735 | 2007-12-03 |
| 1174653406 | Gary Allen Groff | Dentist | 1100 E Ohio St, Clinton, MO 64735 | 2007-03-06 |
| 1306908512 | Andrea Jolynn Bruck | Dentist | 906 E Ohio, Clinton, MO 64735 | 2006-12-14 |
| 1992873889 | Golden Valley Memorial Hospital Home Services | Home Health | 1600 North Second Street, Clinton, MO 64735 | 2006-12-01 |
| 1033205521 | Bradley Mark Townsend | Family Medicine | 1413 South Second Street, Clinton, MO 64735 | 2006-10-04 |
| 1871688473 | Michael Jay Harrison | Chiropractor | 704 E. Ohio, Clinton, MO 64735 | 2006-10-03 |
| Find all providers in zip 64735 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528538758 | Premier Health Care LLC | Internal Medicine | 8023 Malcolm Rd, Clinton, MD 20735-1717 | 2018-11-30 |
| 1871913970 | Whitney Philamlee | Internal Medicine | 2526 Highway 65 S Ste 202, Clinton, AR 72031-6678 | 2014-04-16 |
| 1275967564 | Total Health Internal Medicine, Pllc | Internal Medicine | 602 Beaman St, Unit 606, Clinton, NC 28328-2604 | 2013-08-22 |
| 1649546995 | Mitesh V Shah | Internal Medicine | 7801 Old Branch Ave Ste 202, Clinton, MD 20735-1642 | 2012-03-30 |
| 1013141621 | Shannon S Swift | Internal Medicine | 175 Volunteer Pkwy, Clinton, AR 72031-8001 | 2009-05-11 |
| 1992964316 | Keyteshia Guy | Internal Medicine | 10403 Hospital Dr Ste 103, Clinton, MD 20735-3149 | 2008-06-02 |
| 1265617088 | Paul Edward Viser | Internal Medicine | 603 Beaman St Ste 401, Clinton, NC 28328-2689 | 2007-12-31 |
| 1912119371 | Nancy Patel | Internal Medicine | 700 Plaza Cir Ste N, Clinton, SC 29325 | 2007-05-05 |
| 1760517692 | Anne Owusu | Internal Medicine | 28373 Hwy 76 E, Clinton, SC 29325-0239 | 2007-02-22 |
| 1255479705 | Saleh Obaisi Md Ltd | Internal Medicine | 505 W Side Sq, Clinton, IL 61727-1661 | 2007-02-04 |
| Find all providers in CLINTON | ||||
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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.