So Ri Kim, CRNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

SP023201 Issued in PA

Practice address

2630 Woodland Rd
Abington, PA 19001-3013

Phone

(215) 884-6776

NPI assigned

Apr 27, 2023

Last updated

Apr 27, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

• Via Affiliates

  dba Doylestown Health Vascular Surgery

  • Vascular Surgery Physician
  • Doylestown, PA
  • NPI 1003446261
  Medicare reassignment NPD
• Vitality NP Group LLC

  • Nurse Practitioner
  • Horsham, PA
  • NPI 1003453051

  Gerontology

  Medicare reassignment NPD
• Clinical Specialty Associates

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Bala Cynwyd, PA
  • NPI 1184431900
  Medicare reassignment
• Clinical Specialty Associates

  • Infectious Disease Physician
  • Bala Cynwyd, PA
  • NPI 1932992609
  NPD
• Clinical Specialty Associates

  • Gastroenterology Physician
  • Bala Cynwyd, PA
  • NPI 1992595763
  NPD
• Via Affiliates

  • Psychologist
  • Warrington, PA
  • NPI 1588489272
  NPD
• Via Affiliates

  • Internal Medicine Physician
  • Doylestown, PA
  • NPI 1902913338
  NPD

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

{
    "created_epoch": "1682553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1043908031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 REDBUD LN",
            "city": "FURLONG",
            "state": "PA",
            "postal_code": "189251530",
            "telephone_number": "267-334-3216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 WOODLAND RD",
            "city": "ABINGTON",
            "state": "PA",
            "postal_code": "190013013",
            "telephone_number": "215-884-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SO RI",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-27",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP023201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Safa Khoury, M.D.
• Kendel G Kidwell, MD
• Sara Kietzman, RN, IBCLC
• Ji Yeon Kim, DMD
• Min Soo Kim, M.D.
• Kimberly Anne King, MPT
• Rebecca King
• Amanda M Kingston, M.D.
• Michael Kinsch
• Anne Marie Kinsey, CRNP

• Gerontology Nurse Practitioner in Abington, PA
• Providers in Abington, PA by specialty
• Gerontology Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.