Kathleen Vick Kim, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP138350 Issued in TX

Practice address

5506 Broadway Blvd
Garland, TX 75043-3639

Phone

(972) 303-2400

Fax

(972) 303-4343

NPI assigned

Sep 21, 2018

Sex

Female

Sole proprietor

No

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

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1537488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1346724655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5506 BROADWAY BLVD",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750433639",
            "telephone_number": "972-303-2400",
            "fax_number": "972-303-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5506 BROADWAY BLVD",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750433639",
            "telephone_number": "972-303-2400",
            "fax_number": "972-303-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KATHLEEN",
        "middle_name": "VICK",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-21",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP138350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kid Friendly Pediatrics PA
• Kidnet Foundation
• Zarin Kidwai, MD
• Luke Kientzle
• Joley Dianna Kilgore II
• Brenda Stuart Kimbrell, D.C.
• Mackenzie Kimmons, M.S., CCC-SLP
• Nikki Del Kincy, PT, DPT
• Kinder Anesthesia PLLC
• Kevin Kinder, CRNA

• Pediatric Nurse Practitioner in Garland, TX
• Providers in Garland, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; 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.