Individual provider Active NPI

Yong Kim, PHARM. D.

  • Pharmacist
  • Phoenix, AZ
National Provider Identifier
1417385220
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
I010174 Issued in AZ
Practice address
2921 N 83Rd Ave
Phoenix, AZ 85033-4761
Phone
(623) 849-9300
NPI assigned
Oct 15, 2013
Last updated
Oct 2, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X I010174 AZ Primary

Addresses

Primary practice location

2921 N 83Rd Ave
Phoenix, AZ 85033-4761

Mailing address

411 E Indian School Rd
Apt #2083
Phoenix, AZ 85012-1844
Phone (714) 335-1131

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
I010174AZMDPharmacist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1381795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443744000000",
    "number": "1417385220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 E INDIAN SCHOOL RD",
            "address_2": "APT #2083",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121844",
            "telephone_number": "714-335-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 N 83RD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850334761",
            "telephone_number": "623-849-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YONG",
        "credential": "PHARM. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-15",
        "last_updated": "2015-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "I010174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; 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.