Jeong J Kim, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP30007330 Issued in WA

Practice address

1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001

Phone

(253) 433-5420

NPI assigned

Jun 29, 2006

Last updated

Sep 21, 2021By 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 WA

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

Practice roles

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.

• Multicare Health System

  dba MultiCare Deaconess Retail Pharmacy

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD (past)
• Pacific Lutheran University

  • Family Nurse Practitioner
  • Tacoma, WA
  • NPI 1306915053
  NPD (past)

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1184652026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "city": "TRIPLER AMC",
            "state": "HI",
            "postal_code": "968595001",
            "telephone_number": "808-433-3587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "city": "TRIPLER ARMY MEDICAL CENTER",
            "state": "HI",
            "postal_code": "968595001",
            "telephone_number": "253-433-5420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9332 Bridgeport Way SW",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "WA",
            "postal_code": "984991569",
            "country_code": "US",
            "telephone_number": "253-459-6065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JEONG",
        "middle_name": "J",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2021-09-21",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30007330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maya Khalil, PA
• Chitrod Khaykham, OTR
• Kori Kanoelani Kiesel-Weatherford, LCSW, DCSW, BCD
• Daeyun Kim, PHYSICIAN ASSISTANTS
• Daniel Jongtae Kim, MD
• Jong Kil Kim, DDS
• Marina Catherine Kim, DO
• Minhwan Kim, MD
• Scott Hyuk Kim, MD
• Soyoung Kim

• Family Nurse Practitioner in Tripler Army Medical Center, HI
• Providers in Tripler Army Medical Center, HI by specialty
• Family Nurse Practitioner in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.