Grace Kim, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95007722 Issued in CA

Practice address

12900 Park Plaza Dr
Cerritos, CA 90703-9329

Phone

(562) 622-2800

NPI assigned

Jan 16, 2018

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: grace.kim.1@30710.direct.athenahealth.com

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.

• Albion Medical Partners of California West P C

  • Internal Medicine Physician
  • Cerritos, CA
  • NPI 1073110607
  Medicare reassignment NPD

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

{
    "created_epoch": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1205344967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10487 ELDERBERRY LN",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906706908",
            "telephone_number": "562-266-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900 PARK PLAZA DR",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907039329",
            "telephone_number": "562-622-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10487 Elderberry Ln",
            "address_purpose": "LOCATION",
            "city": "Santa Fe Springs",
            "state": "CA",
            "postal_code": "906706908",
            "country_code": "US",
            "telephone_number": "562-266-8606",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10487 Elderberry Ln",
            "address_purpose": "LOCATION",
            "city": "Santa Fe Springs",
            "state": "CA",
            "postal_code": "906706908",
            "country_code": "US",
            "telephone_number": "562-266-8606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "GRACE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-16",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95007722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Don Ho Kim, L.AC.
• Don Joon Kim, PHARMD
• Elizabeth Kim, MFT-TRAINEE
• Ethan Daniel Sung Soo Kim
• Eui Kyoung Kim
• Haley Kim, MA
• Jennifer Jihye Kim
• Jessica Wiedemann Kim, FNP
• John Shin Kim, M.D.
• Kasey Kim, MD

• Family Nurse Practitioner in Cerritos, CA
• Providers in Cerritos, 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 Apr 5, 2018; 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.