Active NPI
Namsu Kim, FNP
- Family Nurse Practitioner
- New York, NY
National Provider Identifier
1477954907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F338485-1
- Practice address
- 18 E Broadway
Room 628
New York, NY 10002-6803 - Phone
- (212) 226-6002
- NPI assigned
- Sep 16, 2014
- Last updated
- Sep 16, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F338485-1 | NY | Primary |
Addresses
Primary practice location
18 E Broadway
Room 628
New York, NY 10002-6803
Mailing address
620 Reiss PL Apt 5K
Bronx, NY 10467-8060
Phone (718) 290-5055
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171012002543 | NY | Order and Referring Only - Nurse Practitioner | 1456675529 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F338485-1 | NY | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410825600000",
"number": "1477954907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 REISS PL APT 5K",
"city": "BRONX",
"state": "NY",
"postal_code": "104678060",
"telephone_number": "718-290-5055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 E BROADWAY",
"address_2": "ROOM 628",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100026803",
"telephone_number": "212-226-6002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "NAMSU",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-16",
"last_updated": "2014-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F338485-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.