Kristin Marie Kim, PHARMACIST

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

043497 Issued in NY

Practice address

5147 Burnside Dr
Jamesville, NY 13078

Phone

(315) 882-2065

NPI assigned

Feb 1, 2021

Last updated

Feb 1, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1316538580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5147 BURNSIDE DR",
            "city": "JAMESVILLE",
            "state": "NY",
            "postal_code": "13078",
            "telephone_number": "315-882-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5147 BURNSIDE DR",
            "city": "JAMESVILLE",
            "state": "NY",
            "postal_code": "13078",
            "telephone_number": "315-882-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PHARMACIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-01",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NY",
            "license": "043497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrated Medicine of Syracuse
• Iroquois Nursing Home Inc
• Jamesville Family Medicine and Wellness PC
• Cathy Jaworski
• Rangachar Keshava Prasad, M.D.
• Susi Koshy, N.P
• Ralph B Krutulis, D.C.
• Alexandra Marie Lanzafame
• Jeannette Marie Lasala, RN
• Kaylee S Leroy, RN

• Long Term Care Pharmacy in Jamesville, NY
• Providers in Jamesville, NY by specialty
• Long Term Care Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; 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.