Active NPI
Su Hyun Kim
- Pharmacist
- Montgomery, AL
National Provider Identifier
1447830286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21361
- Practice address
- 1725 Pine St
Montgomery, AL 36106-1117 - Phone
- (334) 293-8000
- NPI assigned
- Apr 14, 2021
- 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 | 21361 | AL | Primary |
Addresses
Primary practice location
1725 Pine St
Montgomery, AL 36106-1117
Mailing address
2139 Autumn Ridge Way
Auburn, AL 36879-4639
Phone (240) 723-6341
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1990908194 | Other | ALIEN NUMBER |
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 |
|---|---|---|---|
| 21361 | AL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618358400000",
"number": "1447830286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2139 AUTUMN RIDGE WAY",
"city": "AUBURN",
"state": "AL",
"postal_code": "368794639",
"telephone_number": "240-723-6341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1725 PINE ST",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361061117",
"telephone_number": "334-293-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SU HYUN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-14",
"last_updated": "2021-04-14",
"certification_date": "2021-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "21361",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALIEN NUMBER",
"identifier": "1990908194",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.