Individual provider Active NPI

Lindsey Kim, DNP, APRN, FNP-BC

  • Family Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1205425972
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95019634 Issued in CA
Practice address
4800 E Los Coyotes Diagonal
Long Beach, CA 90815-2897
Phone
(562) 506-1313
NPI assigned
Jan 15, 2021
Last updated
Oct 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.022570 IL
Family Nurse Practitioner 363LF0000X 95019634 CA Primary
Emergency Registered Nurse 163WE0003X 041.369276 IL

Addresses

Primary practice location

4800 E Los Coyotes Diagonal
Long Beach, CA 90815-2897

Mailing address

1950 W Corporate Way
Anaheim, CA 92801-5373

Other names 1

  • Lindsey J Kim Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220526000400 CA Practitioner - Nurse Practitioner 3779961115 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Roads Foundation, IncGroup PAC ID 2961722558, 57 clinicians

Practice addresses (Care Compare)

121 S Long Beach Blvd
Compton, CA 90221-3423
Phone (310) 627-5850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041.369276ILMDEmergency Registered Nurse
209.022570ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Valley Emergency Medical Associates, Inc Multi-Specialty CurrentSince Apr 11, 2022 Accepting new patients
The Roads Foundation, Inc. Multi-Specialty CurrentSince Jul 9, 2024 Accepting new patients
The Roads Foundation, Inc CurrentSince Jul 9, 2024 Accepting new patients

Locations

121 S Long Beach Blvd
Compton, CA 90221
Phone (310) 627-5850

4525 E Atherton St
Long Beach, CA 90815
Phone (562) 961-0155

4800 E Los Coyotes Diagonal
Long Beach, CA 90815
Phone (310) 627-5850

9080 Colima Rd
Whittier, CA 90605
Phone (562) 907-1565

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BFCDAD

Organizations & group practices 3

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": "1610668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1205425972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 W CORPORATE WAY",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928015373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 E LOS COYOTES DIAGONAL",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908152897",
            "telephone_number": "562-506-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "LINDSEY",
        "credential": "DNP, APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-15",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.022570",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95019634",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "IL",
            "license": "041.369276",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSEY",
            "last_name": "KIM",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.