NPIMap

Individual provider Active NPI

Jessica Kim Kim, D.O.

  • Diagnostic Radiology Physician
  • Greenville, NC
National Provider Identifier
1558700427
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
5101020746 Issued in MI
Practice address
2101 W Arlington Blvd Ste 210
Greenville, NC 27834-5758
Phone
(252) 931-7638
Fax
(252) 931-7694
NPI assigned
Jun 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 5101020746 MI Primary

Addresses

Primary practice location

2101 W Arlington Blvd Ste 210
Greenville, NC 27834-5758

Mailing address

PO Box 30750
Greenville, NC 27833-0750
Phone (252) 931-7638

Other names 1

  • Mrs. Jessica Kim Lascola Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191106002499 NC Practitioner - Diagnostic Radiology 1456610732 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
At Still University, Arizona School of Dentistry & Oral HLTH, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Radiologists IncGroup PAC ID 2466355383, 92 clinicians
Weiser Valley Hospital DistrictGroup PAC ID 5294704276, 60 clinicians
Boise Radiology Group PLLCGroup PAC ID 9638153257, 64 clinicians
East Carolina UniversityGroup PAC ID 0244143246, shared by 3 NPIs, 499 clinicians

Practice addresses (Care Compare)

2101 W Arlington Blvd
Suite 210
Greenville, NC 27834-5758
Phone (252) 752-5000

3012 Rolston Rd
Greenville, NC 27858-6253
Phone (208) 433-9466

402 Bowman Gray Dr
Greenville, NC 27834-7209
Phone (252) 752-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101020746MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina University Current Accepting new patients
Sentara Advanced Imaging Solutions, LLC Diagnostic Radiology CurrentSince Jan 1, 2024 Accepting new patients
Weiser Valley Hospital District Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients
Open Sided MRI of Las Vegas, LLC Diagnostic Radiology CurrentSince Apr 1, 2026 Accepting new patients
East Carolina University CurrentSince Dec 1, 2022 Accepting new patients
Boise Radiology Group PLLC Diagnostic Radiology CurrentSince Feb 26, 2026 Accepting new patients
Open Sided MRI of Las Vegas, LLC CurrentSince Apr 1, 2026 Accepting new patients
Eastern Radiologists Inc Diagnostic Radiology CurrentSince Sep 1, 2019 Accepting new patients
East Carolina University Diagnostic Radiology CurrentSince Dec 1, 2025 Accepting new patients

Locations

645 E 5th St
Weiser, ID 83672
Phone (208) 549-0370

600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

2101 W Arlington Blvd
Ste 210
Greenville, NC 27834
Phone (252) 931-7638

402 Bowman Gray Dr
Greenville, NC 27834
Phone (252) 744-9490

630 E 11th St
Washington, NC 27889
Phone (252) 946-2137

Organizations & group practices 9

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1558700427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30750",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278330750",
            "telephone_number": "252-931-7638",
            "fax_number": "252-931-7694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 W ARLINGTON BLVD STE 210",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345758",
            "telephone_number": "252-931-7638",
            "fax_number": "252-931-7694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JESSICA",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-24",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "5101020746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "LASCOLA",
            "middle_name": "KIM",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.