Active NPI
Mi Kim
- Pharmacist
- Stone Ridge, VA
National Provider Identifier
1467744011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202010570
- Practice address
- 42015 Village Center PLZ Ste 110
Stone Ridge, VA 20105-3031 - Phone
- (703) 542-8344
- NPI assigned
- May 13, 2011
- 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 | 0202010570 | VA | Primary |
Addresses
Primary practice location
42015 Village Center PLZ Ste 110
Stone Ridge, VA 20105-3031
Mailing address
42015 Village Center PLZ Ste 110
Stone Ridge, VA 20105-3031
Phone (703) 542-8344
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 |
|---|---|---|---|
| 0202010570 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harris Teeter LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Apex, NC
- NPI 1225856859
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305244800000",
"number": "1467744011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42015 VILLAGE CENTER PLZ STE 110",
"city": "STONE RIDGE",
"state": "VA",
"postal_code": "201053031",
"telephone_number": "703-542-8344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42015 VILLAGE CENTER PLZ STE 110",
"city": "STONE RIDGE",
"state": "VA",
"postal_code": "201053031",
"telephone_number": "703-542-8344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "MI",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-13",
"last_updated": "2011-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202010570",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stone Ridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.