Active NPI
Joohae Kim
- Pharmacist
- Bronx, NY
National Provider Identifier
1174171508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 065840
- Practice address
- 255 E Gun Hill Rd
Bronx, NY 10467-2109 - Phone
- (718) 654-2200
- NPI assigned
- Aug 28, 2019
- Last updated
- Aug 28, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 065840 | NY | Primary |
Addresses
Primary practice location
255 E Gun Hill Rd
Bronx, NY 10467-2109
Mailing address
255 E Gun Hill Rd
Bronx, NY 10467-2109
Phone (718) 654-2200
Other practice location 1
255 E Gun Hill Rd
Bronx, NY 10467-2109
Phone (718) 654-2200
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 |
|---|---|---|---|
| 065840 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KMN Pharmacy Corp | Current | Accepting new patients | |
| KMN Pharmacy Corp | Past | Accepting new patients |
Locations
255 E Gun Hill Rd
Bronx, NY 10467
Phone (718) 654-1685
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566950400000",
"number": "1174171508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 E GUN HILL RD",
"city": "BRONX",
"state": "NY",
"postal_code": "104672109",
"telephone_number": "718-654-2200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 E GUN HILL RD",
"city": "BRONX",
"state": "NY",
"postal_code": "104672109",
"telephone_number": "718-654-2200"
}
],
"practiceLocations": [
{
"address_1": "255 E Gun Hill Rd",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "104672109",
"country_code": "US",
"telephone_number": "718-654-2200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "JOOHAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-28",
"last_updated": "2019-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "065840",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.