Active NPI
Sarah J Kang, FNP
- Family Nurse Practitioner
- Herndon, VA
National Provider Identifier
1013280288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 0024169827
- Practice address
- 555 Herndon Pkwy
# 100
Herndon, VA 20170 - Phone
- (703) 481-1505
- Fax
- (703) 742-8793
- NPI assigned
- Feb 17, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024169827 | VA | Primary |
Addresses
Primary practice location
555 Herndon Pkwy
# 100
Herndon, VA 20170
Mailing address
PO Box 791128
Baltimore, MD 21279
Phone (703) 391-2030
Other names 1
- Joo Yon Kim
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024169827 | VA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairfax Family Practice Centers PC | Family | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Herndon, VA
- NPI 1205944964
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355961600000",
"number": "1013280288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 791128",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21279",
"telephone_number": "703-391-2030",
"fax_number": "703-273-3943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 HERNDON PKWY",
"address_2": "# 100",
"city": "HERNDON",
"state": "VA",
"postal_code": "20170",
"telephone_number": "703-481-1505",
"fax_number": "703-742-8793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANG",
"first_name": "SARAH",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-17",
"last_updated": "2012-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "VA",
"license": "0024169827",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JOO",
"last_name": "KIM",
"middle_name": "YON",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Herndon, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.