Individual provider Active NPI

David J Kim, PHARMD

  • Pharmacist
  • Rochester, NY
National Provider Identifier
1477044329
Registry record updated May 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
063874 Issued in NY
Practice address
1436 W Ridge Rd
Rochester, NY 14615-2411
Phone
(585) 663-4240
NPI assigned
May 27, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 063874 NY Primary

Addresses

Primary practice location

1436 W Ridge Rd
Rochester, NY 14615-2411

Mailing address

241 Alexander St Apt B3
Rochester, NY 14607-2519
Phone (917) 284-2612

Other practice location 1

4433 Dewey Ave
Rochester, NY 14616-1223
Phone (585) 865-8890

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
063874NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1527379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527379200000",
    "number": "1477044329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 ALEXANDER ST APT B3",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146072519",
            "telephone_number": "917-284-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 W RIDGE RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146152411",
            "telephone_number": "585-663-4240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4433 Dewey Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146161223",
            "country_code": "US",
            "telephone_number": "585-865-8890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-27",
        "last_updated": "2018-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "063874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2018; 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.