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Export Provider Record NPI 1285884007
Min Jin Jung DetrickPA-C
Active
NPI Number1285884007
NPI TypeNPI-1 Individual
SpecialtyPhysician Assistant
Provider Details
NPI1285884007
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2008-09-29
Last Updated2024-03-28
Mailing Address3300 Gallows Rd
Falls Church, VA 22042-3307
United States
Phone: (703) 776-4001 | Fax: (703) 776-7113
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Primary Practice Address8100 Boone Blvd Ste 700
Tysons, VA 22182-2683
United States
Phone: (703) 531-2269
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No363A00000X – Physician AssistantNC0010-01553
Yes363A00000X – Physician AssistantVA0110003714
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About NPI 1285884007

Min Jin Jung Detrick PA-C is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1285884007. The primary specialty listed is Physician Assistant. The provider is located in Tysons, VA. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2008-09-29. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1285884007?

NPI 1285884007 belongs to Min Jin Jung Detrick PA-C, a Physician Assistant in Tysons, VA. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1285884007 active?

The current status of NPI 1285884007 in the NPPES registry is Active. The record was last updated on 2024-03-28.

What specialty is NPI 1285884007?

NPI 1285884007 is classified under the taxonomy Physician Assistant. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1285884007?

You can verify NPI 1285884007 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1285884007?

The primary practice address on file for NPI 1285884007 is 8100 Boone Blvd Ste 700, Tysons, VA 22182-2683. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1285884007 issued?

NPI 1285884007 was first issued (enumerated) on 2008-09-29. The NPPES record was last updated on 2024-03-28.

Practice Location Map

Min Jin Jung Detrick is located at 8100 Boone Blvd Ste 700, Tysons, VA. Use the map below to find directions or verify the practice location.

📍 8100 Boone Blvd Ste 700, Tysons, VA 22182-2683  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Min Jin Jung Detrick. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1285884007. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Physician Assistant0010-01553NC
Physician Assistant0110003714VA
Data Verified from CMS NPPES Last synced: 2026-08-03 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162