Jkim Eye Care, O.D., PLLC

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

0618001515 Issued in VA

Legal business name

JKIM EYE CARE, O.D., PLLC

Practice address

5707 Centre Square Dr
Centreville, VA 20120-1916

Phone

(703) 815-2500

Fax

(703) 815-2501

NPI assigned

May 10, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Joo Han Kim, OD

Title

Principal Memeber

Phone

(703) 815-2500

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552003200000",
    "number": "1225528714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5707 CENTRE SQUARE DR",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201201916",
            "telephone_number": "703-815-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5707 CENTRE SQUARE DR",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201201916",
            "telephone_number": "703-815-2500",
            "fax_number": "703-815-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JKIM EYE CARE, O.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-10",
        "last_updated": "2019-03-08",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JOO",
        "authorized_official_middle_name": "HAN",
        "authorized_official_title_or_position": "PRINCIPAL MEMEBER",
        "authorized_official_telephone_number": "703-815-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "VA",
            "license": "0618001515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRY",
            "identifier": "1376664748",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Connie Collins Johnson, PT
• Breon Jones, DC

• Corneal and Contact Management Optometrist in Centreville, VA
• Providers in Centreville, VA by specialty
• Corneal and Contact Management Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2019; 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.