Individual provider Active NPI

Ju Hyung Kim, ANP

  • Nurse Practitioner
  • Milford, MI
National Provider Identifier
1295065308
Registry record updated Nov 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704431271 Issued in MI
Practice address
555 Highland Ave
Milford, MI 48381-1517
Phone
(248) 685-1460
NPI assigned
Jan 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704431271 MI Primary

Addresses

Primary practice location

555 Highland Ave
Milford, MI 48381-1517

Mailing address

265 Brookview Centre Way Ste 203
Knoxville, TN 37919-4053
Phone (865) 500-1353

Other identifiers 1

IdentifierTypeStateIssuer
1295065308MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140122000005 DC Practitioner - Nurse Practitioner 7618006917 Reassigns benefits to 3 organizations
I20251120001673 MI Practitioner - Nurse Practitioner 7618006917 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1643 NW 136 Ave
Sunrise, FL 33323-2857

1643 Nw136 Ave
BLDG H Suite 100
Sunrise, FL 33323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704431271MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. CurrentSince Dec 1, 2013 Accepting new patients
Michigan Post-Acute Medical Services 1 PC CurrentSince Nov 24, 2025 Accepting new patients
CS Pacs 3 Midwest LLC CurrentSince Nov 24, 2025 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Dec 1, 2013 Accepting new patients
Mi Pacs 2 PC CurrentSince Nov 14, 2025 Accepting new patients
Fair Oaks Hospitalist Physicians, PLLC CurrentSince Feb 1, 2015 Accepting new patients
Inova Health Care Services Current Accepting new patients
Inpatient Consultants of Missouri Inc Past Accepting new patients

Locations

22600 W Main St
Armada, MI 48005
Phone (734) 508-4569

12200 Broadbent Rd
Lansing, MI 48917
Phone (517) 731-6200

3310 W Commerce Rd
Milford, MI 48380
Phone (248) 685-1400

555 Highland Ave
Milford, MI 48381
Phone (248) 684-1564

6827 Whitehall Rd
Whitehall, MI 49461
Phone (231) 893-8730

625 36th St SW
Wyoming, MI 49509
Phone (517) 481-3715

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1263254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764288000000",
    "number": "1295065308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 BROOKVIEW CENTRE WAY STE 203",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194053",
            "telephone_number": "865-500-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 HIGHLAND AVE",
            "city": "MILFORD",
            "state": "MI",
            "postal_code": "483811517",
            "telephone_number": "248-685-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JU HYUNG",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-12",
        "last_updated": "2025-11-28",
        "certification_date": "2025-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704431271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295065308",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, MI

Sources for this page

Verify at the official NPI Registry.