Individual provider Active NPI

Soon Bum Kwon

  • Pharmacist
  • Philadelphia, PA
National Provider Identifier
1295528545
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP454049 Issued in PA
Practice address
117 S 20TH St
Philadelphia, PA 19103-4606
Phone
(215) 867-8777
NPI assigned
May 28, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP454049 PA Primary

Addresses

Primary practice location

117 S 20TH St
Philadelphia, PA 19103-4606

Mailing address

117 S 20TH St
Philadelphia, PA 19103-4606
Phone (215) 867-8777

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

State licenses

LicenseStateTypeSpecialty
RP454049PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Capsule Philadelphia LLC CurrentSince Jun 3, 2025 Accepting new patients
Capsule Philadelphia LLC CurrentSince Jun 3, 2025 Accepting new patients

Locations

117 S 20th St
Philadelphia, PA 19103
Phone (215) 867-8777

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1748390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1295528545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 S 20TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191034606",
            "telephone_number": "215-867-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S 20TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191034606",
            "telephone_number": "215-867-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "SOON BUM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-28",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP454049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.