Active NPI
Tae Kyung Kim
- Pharmacist
- Richmond, CA
National Provider Identifier
1487067732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 66566
- Practice address
- 901 Nevin Ave
Richmond, CA 94801-3143 - Phone
- (510) 307-3114
- NPI assigned
- Jun 4, 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 66566 | CA | Primary |
Addresses
Primary practice location
901 Nevin Ave
Richmond, CA 94801-3143
Mailing address
106 Lakeshore CT
Richmond, CA 94804-7422
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrifty Payless Inc | Past | Accepting new patients | |
| Thrifty Payless Inc | Past | Accepting new patients |
Organizations & group practices 2
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
- Oakland, CA
- NPI 1235248725
-
- Community/Retail Pharmacy
- Winchester, CA
- NPI 1437874062
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648425600000",
"number": "1487067732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 LAKESHORE CT",
"city": "RICHMOND",
"state": "CA",
"postal_code": "948047422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 NEVIN AVE",
"city": "RICHMOND",
"state": "CA",
"postal_code": "948013143",
"telephone_number": "510-307-3114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "TAE",
"middle_name": "KYUNG",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-04",
"last_updated": "2022-03-28",
"certification_date": "2022-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "66566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.