Active NPI
Imshin Oh Kim, FNP
- Family Nurse Practitioner
- Columbia, SC
National Provider Identifier
1386886950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 341727
- Practice address
- 4500 Stuart St
Columbia, SC 29207-5700 - Phone
- (803) 751-2273
- NPI assigned
- Mar 29, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 500322 | NY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Nurse Practitioner | 363LF0000X | 341727 | NY | Primary |
Addresses
Primary practice location
4500 Stuart St
Columbia, SC 29207-5700
Mailing address
1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone (912) 435-6965
Other practice location 1
1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone (912) 435-6965
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 500322 | NY | MD | Basic Emergency Medical Technician |
| 341727 | NY | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689033600000",
"number": "1386886950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1061 HARMON AVE",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "313145641",
"telephone_number": "912-435-6965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 STUART ST",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292075700",
"telephone_number": "803-751-2273"
}
],
"practiceLocations": [
{
"address_1": "1061 Harmon Ave",
"address_purpose": "LOCATION",
"city": "Fort Stewart",
"state": "GA",
"postal_code": "313145641",
"country_code": "US",
"telephone_number": "912-435-6965",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "IMSHIN",
"middle_name": "OH",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-29",
"last_updated": "2023-07-11",
"certification_date": "2023-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "500322",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "341727",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.