Jeong Nam Kim-Judd, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2011032430 Issued in MO

Practice address

637 Dunn Rd Ste 180
Hazelwood, MO 63042-1759

Phone

(314) 838-7912

Fax

(314) 921-6283

NPI assigned

Aug 22, 2007

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

Other names 1

• Jeong Nam Kim Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeong.kimjudd.p1@direct.essehealth.nextgenshare.com
• Direct secure messaging: jeongkimjudd@mhccaremail.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• American Multispecialty Group Inc.

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1972559532

  Pediatrics

  NPD

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1013100122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419052",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631419052",
            "telephone_number": "314-851-1000",
            "fax_number": "314-851-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 DUNN RD STE 180",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421759",
            "telephone_number": "314-838-7912",
            "fax_number": "314-921-6283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM-JUDD",
        "first_name": "JEONG",
        "middle_name": "NAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "IL036128909",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2011032430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEONG NAM",
            "last_name": "KIM",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marketa Kasalova, M.D.
• Jamika Kemper, RN
• Caitlin Keohane, MS
• Shawn Khosla
• Robert Joseph Killion, MS,LAT,ATC
• Andrew M. Kim, D.M.D.
• Jaclyn Jeonghoon Kim, MD
• Maria Wong Kim, D.M.D.
• Kindred Connections Nemt Services, LLC
• Donna Renae King, MA, LPC

• Pediatrics Physician in Hazelwood, MO
• Providers in Hazelwood, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.