Individual provider Active NPI

Hee-Jin B Kim, CNP

  • Nurse Practitioner
  • Ann Arbor, MI
National Provider Identifier
1023457140
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704243108 Issued in MI
Practice address
1500 E Medical Center Drive
B2 Floor University Hospital RM C490
Ann Arbor, MI 48109-5010
Phone
(734) 936-4300
NPI assigned
Jun 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704243108 MI Primary
Adult Health Nurse Practitioner 363LA2200X 4704243108 MI

Addresses

Primary practice location

1500 E Medical Center Drive
B2 Floor University Hospital RM C490
Ann Arbor, MI 48109-5010

Mailing address

3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131016001004 MI Practitioner - Nurse Practitioner 2961636410 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of MichiganGroup PAC ID 3779496856, 3,344 clinicians

Practice addresses (Care Compare)

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4000

Hospital & facility affiliations

  • University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704243108MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Nurse Practitioner CurrentSince Jan 10, 2017 Accepting new patients
University Physician Group CurrentSince Jan 1, 2017 Accepting new patients
Regents of the University of Michigan CurrentSince Jan 10, 2017 Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

1500 E Medical Center Dr
Rm C490
Ann Arbor, MI 48109
Phone (734) 936-4300

3621 S State St
#700
Ann Arbor, MI 48108

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

3990 John R St
Detroit, MI 48201
Phone (313) 745-6211

31995 Northwestern Hwy
Farmington Hills, MI 48334
Phone (248) 538-4701

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1371772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1023457140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DRIVE",
            "address_2": "B2 FLOOR UNIVERSITY HOSPITAL RM C490",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095010",
            "telephone_number": "734-936-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HEE-JIN",
        "middle_name": "B",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-21",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704243108",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704243108",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.