Individual provider Active NPI

Minjung Kong, PHARMD

  • Pharmacist
  • Lee's Summit, MO
National Provider Identifier
1235725896
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2020040572 Issued in MO
Practice address
1801 E Langsford Rd
Lees Summit, MO 64063-6323
Phone
(816) 554-0403
NPI assigned
Dec 17, 2020
Last updated
Mar 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2020040572 MO Primary

Addresses

Primary practice location

1801 E Langsford Rd
Lees Summit, MO 64063-6323

Mailing address

2903 NE 59TH Ter Apt 6
Gladstone, MO 64119-2158
Phone (201) 937-7400

Other practice location 1

2903 NE 59th Ter Apt 6
Gladstone, MO 64119-2158
Phone (201) 937-7400

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
2020040572MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1235725896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2903 NE 59TH TER APT 6",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "641192158",
            "telephone_number": "201-937-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 E LANGSFORD RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640636323",
            "telephone_number": "816-554-0403"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2903 NE 59th Ter Apt 6",
            "address_purpose": "LOCATION",
            "city": "Gladstone",
            "state": "MO",
            "postal_code": "641192158",
            "country_code": "US",
            "telephone_number": "201-937-7400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONG",
        "first_name": "MINJUNG",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-17",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2020040572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.