Jody Sook Kim, L.AC.,OMD

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

1053 Issued in NC

Practice address

706A N Reilly Rd
Fayetteville, NC 28303-5619

Phone

(910) 868-8865

NPI assigned

May 14, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1114133642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706A N REILLY RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035619",
            "telephone_number": "910-868-8865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706A N REILLY RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035619",
            "telephone_number": "910-868-8865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "521 W Channel Islands Blvd",
            "address_2": "ste 6",
            "address_purpose": "LOCATION",
            "city": "Port Hueneme",
            "state": "CA",
            "postal_code": "930412132",
            "country_code": "US",
            "telephone_number": "805-815-0333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JODY",
        "middle_name": "SOOK",
        "name_prefix": "Dr.",
        "credential": "L.AC.,OMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "7596",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NC",
            "license": "1053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Kiesser, LPN
• Jamie Michele Kilburn, PHARMD
• Gregory Kilpatrick II
• Kim Pryzgoda DDS PA
• Edward Kim, MD
• Joonsung Kim
• Michael S. Kim, OTR/L
• Suzanne Teresa Kim
• Mary Simmons Kinder, MA; PLPC; PLCAS; ABD
• Kindred Care Therapy

• Acupuncturist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Acupuncturist in North Carolina

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