Individual provider Active NPI

Jinna Kim, MD

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1487764866
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00036556 Issued in WA
Practice address
9245 Rainier Ave S
Seattle, WA 98118-5569
Phone
(206) 722-8444
Fax
(206) 721-6310
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00036556 WA Primary

Addresses

Primary practice location

9245 Rainier Ave S
Seattle, WA 98118-5569

Mailing address

PO Box 3835
Seattle, WA 98124-3835
Phone (206) 548-3114

Other identifiers 1

IdentifierTypeStateIssuer
8242620MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040701000094 WA Practitioner - Family Practice 8426035122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Warren Alpert Medical School of Brown University, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neighborcare HealthGroup PAC ID 0143134205, 100 clinicians

Practice addresses (Care Compare)

9245 Rainier Ave S
Seattle, WA 98118-5569
Phone (206) 722-8444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00036556WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborcare Health Current Accepting new patients
Neighborcare Health CurrentSince Oct 11, 2004 Accepting new patients
Neighborcare Health Current Accepting new patients
Neighborcare Health CurrentSince Oct 11, 2004 Accepting new patients
Neighborcare Health Past Accepting new patients

Locations

9245 Rainier Ave S
Seattle, WA 98118
Phone (206) 461-6981

12721 30th Ave NE
Ste 101
Seattle, WA 98125
Phone (206) 417-0326

6020 35th Ave SW
Seattle, WA 98126
Phone (206) 461-6950

1200 12th Ave S
Ste 901
Seattle, WA 98144
Phone (206) 548-3058

4400 37th Ave S
Seattle, WA 98118
Phone (206) 296-4650

2600 SW Holden St
Seattle, WA 98126
Phone (206) 241-0990

1629 N 45th St
Seattle, WA 98103
Phone (206) 633-3350

Interoperability endpoints

  • Direct secure messaging: jkim289604@direct.ochin.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1487764866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3835",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981243835",
            "telephone_number": "206-548-3114",
            "fax_number": "206-762-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9245 RAINIER AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981185569",
            "telephone_number": "206-722-8444",
            "fax_number": "206-721-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JINNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00036556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8242620",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.