Nayeon Kim PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

NAYEON KIM PLLC

Doing business as

LACEY FAMILY CLINIC

Practice address

7503 Pacific Ave SE
Lacey, WA 98503-1874

Phone

(253) 332-0892

NPI assigned

May 21, 2021

Organization subpart

No

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

Authorized official

Name

Nayeon Kim, ARNPNPI 1306452883

Title

Owner/Manager

Phone

(253) 332-0892

Specialties & licenses 1

Addresses

Other names 1

• LACEY FAMILY CLINIC Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nayeon Kim, FNP

  • Family Nurse Practitioner
  • Lakewood, WA
  • NPI 1306452883
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1508431693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 N 7TH AVE SW",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985126316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7503 PACIFIC AVE SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031874",
            "telephone_number": "253-332-0892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAYEON KIM PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "NAYEON",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "253-332-0892",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LACEY FAMILY CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Primary Care Clinic/Center in Lacey, WA
• Providers in Lacey, WA by specialty
• Primary Care Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.