Individual provider Active NPI

Andrew Kim

  • Family Nurse Practitioner
  • Tulare, CA
National Provider Identifier
1316347537
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95000909 Issued in CA
Practice address
901 N Blackstone St
Tulare, CA 93274-7377
Phone
(559) 688-1992
NPI assigned
Aug 25, 2014
Last updated
Nov 18, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95000909 CA Primary

Addresses

Primary practice location

901 N Blackstone St
Tulare, CA 93274-7377

Mailing address

901 N Blackstone St
Tulare, CA 93274-7377
Phone (559) 688-1992

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20171212002118 CA Practitioner - Nurse Practitioner 1052613924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaweah Delta Health Care DistrictGroup PAC ID 6608778790, 110 clinicians

Practice addresses (Care Compare)

325 S Willis St
Visalia, CA 93291-6105
Phone (559) 624-4080

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95000909CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kaweah Delta Health Care District Current Accepting new patients
Kaweah Delta Health Care District CurrentSince Nov 9, 2017 Accepting new patients
Kaweah Delta Health Care District CurrentSince Nov 9, 2017 Accepting new patients
Kaweah Delta Health Care District Past Accepting new patients
Valley Health Team, Inc Past Accepting new patients

Locations

839 Sequoia Ave
Lindsay, CA 93247
Phone (559) 302-7413

1110 S Ben Maddox Way
#B
Visalia, CA 93292
Phone (559) 624-4800

325 S Willis St
Visalia, CA 93291
Phone (559) 624-4080

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

840 S Akers St
Visalia, CA 93277
Phone (559) 624-3700

Interoperability endpoints

  • Direct secure messaging: andrew.kim.p4@direct.vht.nextgenshare.com

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1408924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1316347537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N BLACKSTONE ST",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "932747377",
            "telephone_number": "559-688-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N BLACKSTONE ST",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "932747377",
            "telephone_number": "559-688-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-25",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95000909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulare, CA

Sources for this page

Verify at the official NPI Registry.