Active NPI
Mi K Kim, R.N.
- Registered Nurse
- New York, NY
National Provider Identifier
1487965570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 580563-1
- Practice address
- 75 Maiden LN
New York, NY 10038-4810 - Phone
- (212) 405-2320
- Fax
- (212) 477-0795
- NPI assigned
- Jun 23, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 580563-1 | NY | Primary |
Addresses
Primary practice location
75 Maiden LN
New York, NY 10038-4810
Mailing address
971 Andover Ter
Ridgewood, NJ 07450-1001
Phone (201) 543-1335
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 580563-1 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277251200000",
"number": "1487965570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "971 ANDOVER TER",
"city": "RIDGEWOOD",
"state": "NJ",
"postal_code": "074501001",
"telephone_number": "201-543-1335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 MAIDEN LN",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100384810",
"telephone_number": "212-405-2320",
"fax_number": "212-477-0795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "MI",
"middle_name": "K",
"name_prefix": "Mrs.",
"credential": "R.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-23",
"last_updated": "2010-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "580563-1",
"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 Jun 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.