Individual provider Active NPI

Miyoung Kim-Vogel

  • Registered Nurse
  • Sunnyside, NY
National Provider Identifier
1114384807
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
600098 Issued in NY
Practice address
4545 42ND St
Sunnyside, NY 11104-2901
Phone
(718) 361-3300
Fax
(718) 361-3305
NPI assigned
Jan 26, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 600098 NY Primary

Addresses

Primary practice location

4545 42ND St
Sunnyside, NY 11104-2901

Mailing address

4545 42ND St
Sunnyside, NY 11104-2901
Phone (718) 361-3300

Other identifiers 1

IdentifierTypeStateIssuer
600098OtherNYREGISTERED NURSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
600098NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1114384807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 42ND ST",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111042901",
            "telephone_number": "718-361-3300",
            "fax_number": "718-361-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 42ND ST",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111042901",
            "telephone_number": "718-361-3300",
            "fax_number": "718-361-3305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM-VOGEL",
        "first_name": "MIYOUNG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-26",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "600098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "600098",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.