Active NPI
Hanh Kim, APRN, FNP-C
- Family Nurse Practitioner
- San Diego, CA
National Provider Identifier
1568000388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95013501
- Practice address
- 4444 El Cajon Blvd Ste 6
San Diego, CA 92115-4392 - Phone
- (619) 285-1522
- NPI assigned
- Dec 11, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95013501 | CA | Primary |
Addresses
Primary practice location
4444 El Cajon Blvd Ste 6
San Diego, CA 92115-4392
Mailing address
2731 Morava PL
San Diego, CA 92110-2360
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220330000905 | CA | Practitioner - Nurse Practitioner | 4981090040 | Practice locations: San Diego, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95013501 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576195200000",
"number": "1568000388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2731 MORAVA PL",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921102360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4444 EL CAJON BLVD STE 6",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921154392",
"telephone_number": "619-285-1522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "HANH",
"credential": "APRN, FNP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-11",
"last_updated": "2019-12-13",
"certification_date": "2019-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95013501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.