Jessica Kim, DPT
Individual provider Active NPI Physical Therapist · Medina, NY
NPI 1316517014 · NPPES record last updated Jun 25, 2021
Key facts
- NPI
- 1316517014
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 047228 (NY)
- Practice address
- 200 Ohio St
Medina, NY 14103-1063 - Phone
- (585) 798-2000
- NPI assigned
- Jun 25, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 047228 | NY | Yes |
Addresses
Primary practice location
200 Ohio St
Medina, NY 14103-1063
Mailing address
4623 Chestnut Ridge Rd Apt D
Buffalo, NY 14228-3338
Other providers in Medina, NY
- Peter C Igoe
- Incubizness, Inc.
- Alexis Jefferds
- Gary F. Jerge
- Ian Michael Kennedy
- Jill E Klotzbach
- Tanya M Kopp
- Steven G Kratoville
- Lake Plains Medical PLLC
- Wendy Lamirand
All providers in Medina, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.