Individual provider Active NPI

Hyun Jung Kim, PHARMD

  • Pharmacist
  • Phoenix, AZ
National Provider Identifier
1265941116
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S022752 Issued in AZ
Practice address
24416 N 19TH Ave
Phoenix, AZ 85085-1887
Phone
(877) 546-5779
Fax
(877) 546-5780
NPI assigned
Sep 22, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S022752 AZ Primary

Addresses

Primary practice location

24416 N 19TH Ave
Phoenix, AZ 85085-1887

Mailing address

24416 N 19TH Ave
Phoenix, AZ 85085-1887
Phone (877) 546-5779

Other names 1

  • Dr. Evelyn Kim Other name

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
S022752AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1506038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1265941116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24416 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850851887",
            "telephone_number": "877-546-5779",
            "fax_number": "877-546-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24416 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850851887",
            "telephone_number": "877-546-5779",
            "fax_number": "877-546-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HYUN JUNG",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S022752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVELYN",
            "last_name": "KIM",
            "prefix": "DR.",
            "credential": "PHARMD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.