Active NPI
Jina Ann Kim, PHARM D.
- Pharmacist
- Long Island City, NY
National Provider Identifier
1386925113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 055972
- Practice address
- 2125 Broadway
Long Island City, NY 11106-4532 - Phone
- (718) 932-9200
- NPI assigned
- Sep 7, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 055972 | NY | Primary |
Addresses
Primary practice location
2125 Broadway
Long Island City, NY 11106-4532
Mailing address
13910 28TH Rd Apt 4E
Flushing, NY 11354-1808
Phone (347) 610-5733
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
| License | State | Type | Specialty |
|---|---|---|---|
| 055972 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315353600000",
"number": "1386925113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13910 28TH RD APT 4E",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113541808",
"telephone_number": "347-610-5733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2125 BROADWAY",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "111064532",
"telephone_number": "718-932-9200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JINA",
"middle_name": "ANN",
"credential": "PHARM D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-07",
"last_updated": "2011-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "055972",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Island City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.