Jeanhie Frances Kim

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH031559 Issued in GA

Practice address

6095 Pine Mountain Rd NW Ste 108
Kennesaw, GA 30152-3332

Phone

(770) 421-1399

Fax

(866) 635-2329

NPI assigned

Dec 29, 2020

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Innovation Compounding Pharmacy, LLC

  • Pharmacy
  • Kennesaw, GA
  • NPI 1710157342
  NPD (past)

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1225625825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 BARRETT LAKES BLVD NW APT 1122",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301448005",
            "telephone_number": "678-200-7840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6095 PINE MOUNTAIN RD NW STE 108",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523332",
            "telephone_number": "770-421-1399",
            "fax_number": "866-635-2329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JEANHIE",
        "middle_name": "FRANCES",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-29",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH031559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Rae Kibbe, MS, BCBA
• Morgan Kidd, RBT
• Alice Kihara
• Elizabeth Killian, DPT
• Gloria Kim, RN
• Kyoung-Soon Kim, MD
• Myia Frances Kimble, MA, PHLEBOTOMIST
• Kortney Kimura, D.C.
• Aldreques Andros King, PASTORAL COUNSELOR
• Alexandra King, MED.,NCC

• Pharmacist in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.