Rei Mijung Kim

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

345160 Issued in NY

Practice address

6750I 192ND St
Fresh Meadows, NY 11365-3796

Phone

(347) 585-0007

NPI assigned

Oct 10, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1013559152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6750I 192ND ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113653796",
            "telephone_number": "347-585-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750I 192ND ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113653796",
            "telephone_number": "347-585-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "REI",
        "middle_name": "MIJUNG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-10",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "345160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "reimkim@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6750I 192nd St",
            "city": "Fresh Meadows",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113653796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jun Sung Kim, RPH
• Kristy Kim
• Kunyi Kim, PHARMD
• Mirim Kim, P.T.
• NA Ae Kim, PHARMD
• Sora Kim
• Sunhee Kim, RPA
• Tae Kim
• Youjin Kim, P.T.
• Kinetic Health Inc.

• Family Nurse Practitioner in Fresh Meadows, NY
• Providers in Fresh Meadows, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.