Jung Mi Kim

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024176496 Issued in VA

Practice address

24795 Pinebrook Rd
Chantilly, VA 20152-4239

Phone

(866) 389-2727

NPI assigned

Nov 30, 2018

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

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Access PCGroup PAC ID 9335405844, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jung.kim.1@20907.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/16272/brand/1/csg/1/fhir/r4

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.

• Medical Access P.C.

  • Urgent Care Clinic/Center
  • Germantown, MD
  • NPI 1144291204

  DC, VA

  Medicare reassignment Care Compare group NPD
• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  DC

  Medicare reassignment NPD
• Tru Health Group, PC

  • Urgent Care Clinic/Center
  • Germantown, MD
  • NPI 1194471946

  DC

  Medicare reassignment NPD
• Manbir Takhar, P.C.

  • Primary Care Clinic/Center
  • Germantown, MD
  • NPI 1457322505
  NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD

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

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1114497351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11645 LEEHIGH DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24795 PINEBROOK RD",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201524239",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24795 Pinebrook Rd",
            "address_purpose": "LOCATION",
            "city": "South Riding",
            "state": "VA",
            "postal_code": "201524239",
            "country_code": "US",
            "telephone_number": "301-787-2249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JUNG",
        "middle_name": "MI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-30",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024176496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Kim
• Claire Minjung Kim, DPT
• Elijah Hyuk Kim
• Gloria Seon-Young Kim, D.D.S.
• Jenna Kim
• Rachel Eunbee Kim, M.A., CF-SLP
• Seong Hee Kim, RN
• Shanna Kim
• Soo H Kim, O.D.
• Wha Shu Kim

• Family Nurse Practitioner in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; 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.