Active NPI
Jeanette Kim, L.AC.
- Acupuncturist
- New York, NY
National Provider Identifier
1124328661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 2015
- Practice address
- 168 W 86TH St
Suite 1BW
New York, NY 10024-4022 - Phone
- (212) 405-6126
- NPI assigned
- Nov 1, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 2015 | NY | Primary |
Addresses
Primary practice location
168 W 86TH St
Suite 1BW
New York, NY 10024-4022
Mailing address
439 11TH St
Brooklyn, NY 11215-4307
Phone (212) 405-6126
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2015 | NY | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288569600000",
"number": "1124328661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "439 11TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112154307",
"telephone_number": "212-405-6126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "168 W 86TH ST",
"address_2": "SUITE 1BW",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100244022",
"telephone_number": "212-405-6126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JEANETTE",
"credential": "L.AC.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-01",
"last_updated": "2010-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "2015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.