Kacy Eunkyung In, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ00410200 Issued in NJ

Practice address

817 Rahway Ave
Elizabeth
Elizabeth, NJ 07202-2212

Phone

(908) 353-5750

NPI assigned

Sep 6, 2013

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kacy.in.1@23997.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/23997/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.

• Union County Pediatrics Group Inc

  • Pediatrics Physician
  • Elizabeth, NJ
  • NPI 1831379841
  NPD (past)

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

{
    "created_epoch": "1378425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1124453311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 STRATFORD RD",
            "address_2": "ENGLEWOOD CLIFFS",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076321925",
            "telephone_number": "201-944-0670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 RAHWAY AVE",
            "address_2": "ELIZABETH",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072022212",
            "telephone_number": "908-353-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IN",
        "first_name": "KACY",
        "middle_name": "EUNKYUNG",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-06",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00410200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omar Ibrahim, MD
• Idleness Eliminators
• Nkenna Roseline Ijeh
• Maria Christina Ilac, APN, ACNPC-AG
• Shermeen Imtiaz
• Richard A Inacio, DC
• Injury Brake Chiropractic
• Injury Brake Chiropractic Center, LLC
• Innovations Med Spa
• Integrated Wound Specialists of Elizabeth, LLC

• Family Nurse Practitioner in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2013; 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.