Active NPI
John Kim, PHARMD
- Pharmacist
- Vail, CO
National Provider Identifier
1174996193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21095
- Practice address
- 2109 N Frontage Rd W
Vail, CO 81657-4897 - Phone
- (970) 476-1621
- NPI assigned
- Nov 12, 2015
- Sex
- Male
- 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 | 21095 | CO | Primary |
Addresses
Primary practice location
2109 N Frontage Rd W
Vail, CO 81657-4897
Mailing address
1300 N Frontage Rd W # 5318
Vail, CO 81657-9944
Phone (714) 717-0084
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21095 | CO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dillon Companies LLC | Past | Accepting new patients | |
| Dillon Companies LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Fountain, CO
- NPI 1194524165
-
- Community/Retail Pharmacy
- Vail, CO
- NPI 1316982085
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601424000000",
"number": "1174996193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 N FRONTAGE RD W # 5318",
"city": "VAIL",
"state": "CO",
"postal_code": "816579944",
"telephone_number": "714-717-0084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2109 N FRONTAGE RD W",
"city": "VAIL",
"state": "CO",
"postal_code": "816574897",
"telephone_number": "970-476-1621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JOHN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-11-12",
"last_updated": "2020-09-30",
"certification_date": "2020-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "21095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vail, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.