Active NPI
Jong Hee Kim
- Social Worker
- Woodside, NY
National Provider Identifier
1457772378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 121361
- Practice address
- 4015 61St St Apt 7F
Woodside, NY 11377-4924 - Phone
- (718) 687-6109
- NPI assigned
- Dec 18, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Art Therapist | 221700000X | 221700000 | NY | |
| Social Worker | 104100000X | 121361 | NY | Primary |
Addresses
Primary practice location
4015 61St St Apt 7F
Woodside, NY 11377-4924
Mailing address
4015 61St St Apt 7F
Woodside, NY 11377-4924
Phone (718) 687-6109
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 |
|---|---|---|---|
| 121361 | NY | MD | Social Worker |
| 221700000 | NY | MD | Art Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699315200000",
"number": "1457772378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4015 61ST ST APT 7F",
"city": "WOODSIDE",
"state": "NY",
"postal_code": "113774924",
"telephone_number": "718-687-6109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4015 61ST ST APT 7F",
"city": "WOODSIDE",
"state": "NY",
"postal_code": "113774924",
"telephone_number": "718-687-6109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JONG HEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-12-18",
"last_updated": "2023-11-07",
"certification_date": "2023-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "221700000X",
"taxonomy_group": "",
"desc": "Art Therapist",
"state": "NY",
"license": "221700000",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "121361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.