Joanne Kim, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95022581 Issued in CA

Practice address

3657 Van Buren Blvd
Riverside, CA 92503-4249

Phone

(909) 238-7966

NPI assigned

Oct 19, 2022

Last updated

Oct 20, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Eunice Lee Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Evergreen Spine and Pain CentersGroup PAC ID 6507263688, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Evergreen Spine and Pain Centers

  • Interventional Pain Medicine Physician
  • Riverside, CA
  • NPI 1760159198
  Medicare reassignment Care Compare group NPD
• Jkim Nursing, Inc

  • Primary Care Clinic/Center
  • Riverside, CA
  • NPI 1235813528
  NPD Authorized official
• One Mission Medical Inc

  dba One Mission Medical Group

  • Family Medicine Physician
  • Mission Hills, CA
  • NPI 1548856586
  NPD (past)

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1053037192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9961 KAYLOR AVE",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202225",
            "telephone_number": "909-238-7966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3657 VAN BUREN BLVD",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925034249",
            "telephone_number": "909-238-7966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10200 Sepulveda Blvd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Mission Hills",
            "state": "CA",
            "postal_code": "913453323",
            "country_code": "US",
            "telephone_number": "909-238-7966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-19",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95022581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EUNICE",
            "last_name": "LEE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Janice Chin Sun Kim, NP
• Jennifer Kim, MD
• Jeong Doo Kim, M.D, D.D.S
• Ji Young Kim, DMD, MS
• Jin Kim
• Jonathan Kiltai Kim, M.D.
• Jong In Kim, DPM
• Joy Kim, LCSW
• Juhyen Kim
• Julie Kim

• Family Nurse Practitioner in Riverside, CA
• Providers in Riverside, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.