Soonmi Kim

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95018189 Issued in CA

Practice address

1348 W Herndon Ave Ste 101
Fresno, CA 93711-7181

Phone

(559) 573-7260

NPI assigned

Aug 30, 2021

Last updated

Dec 6, 2023By the provider in NPPES

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 CA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sharwin Tafazoli Inc

  • Physical Medicine & Rehabilitation Physician
  • Seattle, WA
  • NPI 1447806278

  CA

  Medicare reassignment
• Arya Healthcare

  • Critical Care Medicine (Internal Medicine) Physician
  • Fresno, CA
  • NPI 1437910734
  NPD

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1144998790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1348 W HERNDON AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937117181",
            "telephone_number": "559-573-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1348 W HERNDON AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937117181",
            "telephone_number": "559-573-7260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SOONMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95018189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillip J Kim, MD, MPH
• Samantha Kim, PHARMD
• Sean Kim, DO
• Shirley Kim, DO
• Soo Y. Kim, M.D.
• Stephanie Eun Young Kim
• Vivian Y Kim, M.D.
• William Taewoo Kim, MD
• Yang J Kim, MD
• Yoon C Kim, RPH

• Family Nurse Practitioner in Fresno, CA
• Providers in Fresno, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.