Active NPI
Jean Y Kim, CRNA
- Certified Registered Nurse Anesthetist
- Falls Church, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 0024167694
- Practice address
- 3300 Gallows Rd
Falls Church, VA 22042-3307 - Phone
- (703) 776-3138
- Fax
- (703) 776-2623
- NPI assigned
- Jan 28, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 0024167694 | VA | Primary |
| Registered Nurse | 163W00000X | R180483 | MD |
Addresses
Primary practice location
3300 Gallows Rd
Falls Church, VA 22042-3307
Mailing address
3100 Spring Forest Rd
Suite 130
Raleigh, NC 27616-2880
Phone (919) 882-0705
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 414417100 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, VA
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2501 Parkers LN
Alexandria, VA 22306-3209
Phone (703) 664-7000
3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-4001
Hospital & facility affiliations
- Inova Fairfax Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inova Health Care Services | Current | Accepting new patients | |
| Northstar Anesthesia of Virginia, LLC | Current | Accepting new patients | |
| American Anesthesiology of Virginia PC | Current | Accepting new patients | |
| American Anesthesiology of Virginia, PC | Current | Accepting new patients | |
| Inova Health Care Services | Current | Accepting new patients | |
| Inova Health Care Services | Current | Accepting new patients |
Locations
1500 Concord Ter
Fl 5
Sunrise, FL 33323
Phone (954) 384-0175
2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000
736 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6124
541 Sunset Ln
Ste 201
Culpeper, VA 22701
Phone (540) 829-0700
3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395
224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894
Organizations & group practices 6
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.
-
- Anesthesiology Physician
- Leesburg, VA
- NPI 1053675199
-
- Multi-Specialty Clinic/Center
- Fairfax, VA
- NPI 1669511051
-
- Medical Technologist
- Sterling, VA
- NPI 1699655589
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital Unit
- Falls Church, VA
- NPI 1588795462
-
- General Acute Care Hospital
- Falls Church, VA
- NPI 1831220714
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402444800000",
"number": "1356528871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 SPRING FOREST RD",
"address_2": "SUITE 130",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276162880",
"telephone_number": "919-882-0705",
"fax_number": "919-873-9821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 GALLOWS RD",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220423307",
"telephone_number": "703-776-3138",
"fax_number": "703-776-2623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JEAN",
"middle_name": "Y",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-28",
"last_updated": "2014-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "VA",
"license": "0024167694",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MD",
"license": "R180483",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "414417100",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Falls Church, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.