Individual provider Active NPI

Mingu Kim

  • Nurse's Aide
  • Mercer Island, WA
National Provider Identifier
1396656120
Registry record updated Sep 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
NC70053234 Issued in WA
Practice address
9150 Fortuna Dr
Mercer Island, WA 98040-3133
Phone
(206) 268-3000
NPI assigned
Sep 12, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X NC70053234 WA Primary

Addresses

Primary practice location

9150 Fortuna Dr
Mercer Island, WA 98040-3133

Mailing address

9150 Fortuna Dr
Mercer Island, WA 98040-3133
Phone (206) 268-3000

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1789171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789171200000",
    "number": "1396656120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9150 FORTUNA DR",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980403133",
            "telephone_number": "206-268-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9150 FORTUNA DR",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980403133",
            "telephone_number": "206-268-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MINGU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-12",
        "last_updated": "2026-09-12",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "WA",
            "license": "NC70053234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mercer Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.