Active NPI
Juyeon Kim, MD
- Anatomic Pathology & Clinical Pathology Physician
- Mobile, AL
National Provider Identifier
1558065268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- L5908R
- Practice address
- 2451 University Hospital Dr BLDG Room120
Mobile, AL 36617-2300 - Phone
- (251) 471-7786
- Fax
- (251) 471-7884
- NPI assigned
- Mar 28, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | L5908R | AL | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
2451 University Hospital Dr BLDG Room120
Mobile, AL 36617-2300
Mailing address
2451 University Hospital Dr BLDG Room120
Mobile, AL 36617-2300
Phone (251) 471-7786
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L5908R | AL | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696809600000",
"number": "1558065268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2451 UNIVERSITY HOSPITAL DR BLDG ROOM120",
"city": "MOBILE",
"state": "AL",
"postal_code": "366172300",
"telephone_number": "251-471-7786",
"fax_number": "251-471-7884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2451 UNIVERSITY HOSPITAL DR BLDG ROOM120",
"city": "MOBILE",
"state": "AL",
"postal_code": "366172300",
"telephone_number": "251-471-7786",
"fax_number": "251-471-7884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JUYEON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-28",
"last_updated": "2023-10-09",
"certification_date": "2023-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "AL",
"license": "L5908R",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.