Active NPI
Jisoo Annice Kim
- Speech-Language Pathologist
- New York, NY
National Provider Identifier
1184069577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 59 Thompson St Apt 14
New York, NY 10012-4360 - Phone
- (917) 734-9894
- NPI assigned
- Apr 30, 2013
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | NY | Primary |
Addresses
Primary practice location
59 Thompson St Apt 14
New York, NY 10012-4360
Mailing address
185 Lenox Ave Apt 1
New York, NY 10026-1381
Phone (917) 734-9894
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393804800000",
"number": "1184069577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "185 LENOX AVE APT 1",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100261381",
"telephone_number": "917-734-9894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "59 THOMPSON ST APT 14",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100124360",
"telephone_number": "917-734-9894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JISOO ANNICE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-30",
"last_updated": "2014-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": null,
"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 Mar 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.