Justin Kim, MDPP COACH

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

7 Broad Ave
Suite 206
Palisades Park, NJ 07650

Phone

(201) 313-0131

NPI assigned

Jun 4, 2018

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Senior Solution Agency LLC

  • Home Health Agency
  • Palisades Park, NJ
  • NPI 1144772872
  NPD (past)
• Senior Solution Agency LLC

  • Home Health Agency
  • Palisades Park, NJ
  • NPI 1417514787
  NPD (past)

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1063904134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BROAD AVE",
            "address_2": "SUITE 206",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "07650",
            "telephone_number": "201-313-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 BROAD AVE",
            "address_2": "SUITE 206",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "07650",
            "telephone_number": "201-313-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JUSTIN",
        "credential": "MDPP COACH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-04",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jinna Kim, OD
• John J Kim, O.D.
• Jonathan Jaeyoung Kim, D.C.
• Julia E. Kim, O.D.
• Jung H Kim, DDS
• Martin Sung Kim, OD
• Sean Kim, DC
• Seung Hee Kim
• Steven Kim, DMD
• Sungsik Kim, D.C.

• Professional Counselor in Palisades Park, NJ
• Providers in Palisades Park, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; 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.