JACKY KIM CHUN PA-C NPI 1164140109

NPI Information

  • NPI: 1164140109
  • Provider Name: JACKY KIM CHUN, PA-C
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 15001 SHADY GROVE RD STE 300
    ROCKVILLE, MD
    ZIP 20850
  • Phone: (301) 340-3252

Map and Directions

Get Directions

NPI Details

Jacky Kim Chun, PA-C is a medical physician assistant in Rockville, MD with 4 years of experience. Jacky Kim Chun, PA-C NPI is 1164140109. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

15001 SHADY GROVE RD STE 300
ROCKVILLE, MD
ZIP 20850-353
Phone: (301) 340-3252
Fax: (301) 340-1423

The NPI 1164140109 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/16/2022 and was last updated on 8/22/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedicalC0008525MARYLANDYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI