Individual provider Active NPI

Jemma Jihyun Kim, PT, DPT

  • Physical Therapist
  • Newark, DE
National Provider Identifier
1275309916
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
JI-0014763 Issued in DE
Practice address
540 S College Ave Ste 160
Newark, DE 19713-1302
Phone
(302) 831-8893
NPI assigned
Dec 4, 2023
Last updated
Dec 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X JI-0014763 DE Primary

Addresses

Primary practice location

540 S College Ave Ste 160
Newark, DE 19713-1302

Mailing address

540 S College Ave Ste 160
Newark, DE 19713-1302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231227000187 DE Practitioner - Physical Therapist in Private Practice 3375993801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ud Health LLCGroup PAC ID 6204209034, 53 clinicians

Practice addresses (Care Compare)

540 S College Ave
Suite 160
Newark, DE 19713-1302
Phone (302) 831-8893

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
JI-0014763DEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ud Health LLC Physical Therapist CurrentSince Nov 13, 2023 Accepting new patients
Ud Health LLC CurrentSince Nov 13, 2023 Accepting new patients

Locations

540 S College Ave
Ste 160
Newark, DE 19713
Phone (302) 831-3000

Interoperability endpoints

  • Direct secure messaging: jemma.kim.p1@direct.udel.nextgenshare.com

Organizations & group practices 2

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": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1275309916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 S COLLEGE AVE STE 160",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197131302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 S COLLEGE AVE STE 160",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197131302",
            "telephone_number": "302-831-8893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JEMMA",
        "middle_name": "JIHYUN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "JI-0014763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.