Chris Kim, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP10540 Issued in AZ

Practice address

9043 W Olive Ave
Peoria, AZ 85345-7049

Phone

(623) 776-2065

NPI assigned

Aug 28, 2017

Last updated

Nov 15, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chris.kim.1@32527.direct.athenahealth.com
• Direct secure messaging: chris.kim.p4@direct.caremorewest.nextgenshare.com
• Direct secure messaging: chris.kim@krogerhealth.eclinicaldirectplus.com

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.

• Amdx, LTD

  dba American Medical Diagnostics

  • Specialist
  • Phoenix, AZ
  • NPI 1275647851
  Medicare reassignment NPD
• Carelon Medical Partners of Arizona, P.C.

  • Family Medicine Physician
  • Tucson, AZ
  • NPI 1972879773
  Medicare reassignment NPD
• The Little Clinic of Arizona LLC

  • Family Nurse Practitioner
  • Buckeye, AZ
  • NPI 1023216249
  Medicare reassignment NPD
• Carelon Medical Partners of Arizona, P.C.

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1730697483
  NPD
• Restassured RX

  • Sleep Disorder Diagnostic Clinic/Center
  • Phoenix, AZ
  • NPI 1700303203
  NPD (past)

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

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1598282832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 W GUADALUPE RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852333321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9043 W OLIVE AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853457049",
            "telephone_number": "623-776-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHRIS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-28",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP10540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "341238",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kids Dental Peoria, LLC
• Kidz R Kool
• John Peter Kieley, MD
• Annette Kietur
• Albert Kim, D.C.
• Melissa Joy Kim, PA-C
• Miji Kim, RPH
• Min Cheol Kim, MD
• Stephanie S Kim
• Kimberly D Nielsen, PLLC

• Family Nurse Practitioner in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; 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.

Verify at the official NPI Registry.