Jeong Beom Kim

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH60658048 Issued in WA

Practice address

2521 Main St
Vancouver, WA 98660-2649

Phone

(360) 693-2524

NPI assigned

Feb 17, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Walgreen Co

  • Pharmacy
  • Vancouver, WA
  • NPI 1467467456
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1487289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1477092880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 NE 124TH AVE UNIT N181",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986821603",
            "telephone_number": "773-459-5525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 MAIN ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602649",
            "telephone_number": "360-693-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JEONG BEOM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-17",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60658048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dong Pil Kim, MD
• Eric Kun Kim, DDS
• Esther J Kim, LCSW
• Hyung J. Kim, M.D.
• Jaesung Kim, M.D.
• John Sung Kim, D.M.D.
• Joseph June Kim, DDS
• Ju Hyung Kim
• Junghee Kim, DMD
• Kalis J Kim, NP

• Pharmacist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; 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.