Individual provider Active NPI

Paul J Kim, PHARM D

  • Pharmacist
  • Philadelphia, PA
National Provider Identifier
1205422524
Registry record updated Dec 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP439005 Issued in PA
Practice address
109 W Chelten Ave
Philadelphia, PA 19144-3301
Phone
(267) 297-6482
Fax
(267) 297-6423
NPI assigned
Dec 21, 2020
Last updated
Dec 21, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP439005 PA Primary

Addresses

Primary practice location

109 W Chelten Ave
Philadelphia, PA 19144-3301

Mailing address

109 W Chelten Ave
Philadelphia, PA 19144-3301
Phone (267) 297-6482

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

LicenseStateTypeSpecialty
RP439005PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kim Pharmaceuticals LLC CurrentSince Dec 27, 2020 Accepting new patients

Locations

109 W Chelten Ave
Philadelphia, PA 19144
Phone (267) 297-6482

Organizations & group practices 1

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": "1608508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1205422524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 W CHELTEN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191443301",
            "telephone_number": "267-297-6482",
            "fax_number": "267-297-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W CHELTEN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191443301",
            "telephone_number": "267-297-6482",
            "fax_number": "267-297-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "PAUL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-21",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP439005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

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

Verify at the official NPI Registry.