Active NPI
Roy Kim, PHARMD
- Pharmacist
- Raleigh, NC
National Provider Identifier
1508471897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 29892
- Practice address
- 3911 Capital Blvd
Raleigh, NC 27604-3411 - Phone
- (919) 872-5233
- NPI assigned
- Sep 13, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 29892 | NC | Primary |
Addresses
Primary practice location
3911 Capital Blvd
Raleigh, NC 27604-3411
Mailing address
451 Methven Grove Dr
Cary, NC 27519-0122
Phone (213) 703-1579
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 29892 | Other | NC | NORTH CAROLINA BOARD OF PHARMACY |
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29892 | NC | MD | Interventional Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
3911 Capital Blvd
Raleigh, NC 27604
Phone (919) 872-5233
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683676800000",
"number": "1508471897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "451 METHVEN GROVE DR",
"city": "CARY",
"state": "NC",
"postal_code": "275190122",
"telephone_number": "213-703-1579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3911 CAPITAL BLVD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276043411",
"telephone_number": "919-872-5233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "ROY",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-13",
"last_updated": "2023-05-10",
"certification_date": "2023-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "29892",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTH CAROLINA BOARD OF PHARMACY",
"identifier": "29892",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.