Individual provider Active NPI

Jong-Min Jonathon Kim, PHARMD

  • Pharmacist
  • Flushing, NY
National Provider Identifier
1356590228
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
047691 Issued in NY
Practice address
14114 Northern Blvd
My Hope Pharmacy LLC
Flushing, NY 11354-4239
Phone
(718) 353-8202
Fax
(718) 353-8134
NPI assigned
Sep 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 047691 NY Primary

Addresses

Primary practice location

14114 Northern Blvd
My Hope Pharmacy LLC
Flushing, NY 11354-4239

Mailing address

14114 Northern Blvd
My Hope Pharmacy LLC
Flushing, NY 11354-4239
Phone (718) 353-8202

Other names 1

  • Dr. Jonathon Kim Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
047691NYMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1356590228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14114 NORTHERN BLVD",
            "address_2": "MY HOPE PHARMACY LLC",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544239",
            "telephone_number": "718-353-8202",
            "fax_number": "718-353-8134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14114 NORTHERN BLVD",
            "address_2": "MY HOPE PHARMACY LLC",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544239",
            "telephone_number": "718-353-8202",
            "fax_number": "718-353-8134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JONG-MIN",
        "middle_name": "JONATHON",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-15",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "047691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JONATHON",
            "last_name": "KIM",
            "prefix": "DR.",
            "credential": "PHARMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; 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.