Individual provider Active NPI

Jessica J Kim, PHARM D

  • Pharmacist
  • Eugene, OR
National Provider Identifier
1427195056
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0010457 Issued in OR
Practice address
4010 Aerial Way
Eugene, OR 97402-9757
Phone
(541) 687-6353
Fax
(541) 242-8413
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0010457 OR Primary

Addresses

Primary practice location

4010 Aerial Way
Eugene, OR 97402-9757

Mailing address

4010 Aerial Way
Eugene, OR 97402-9757
Phone (541) 687-6353

Other practice location 1

1162 Willamette St
Eugene, OR 97401-3568
Phone (541) 687-6156

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
0010457ORMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1427195056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 AERIAL WAY",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974029757",
            "telephone_number": "541-687-6353",
            "fax_number": "541-242-8413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 AERIAL WAY",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974029757",
            "telephone_number": "541-687-6353",
            "fax_number": "541-242-8413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1162 Willamette St",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974013568",
            "country_code": "US",
            "telephone_number": "541-687-6156",
            "fax_number": "541-335-2355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JESSICA",
        "middle_name": "J",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "0010457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; 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.