Individual provider Active NPI

Karen Yoon Kim

  • Pharmacist
  • Alpharetta, GA
National Provider Identifier
1598363244
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH22139 Issued in GA
Practice address
10945 State Bridge Rd
Alpharetta, GA 30022-8164
Phone
(770) 751-3010
NPI assigned
Oct 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH22139 GA Primary

Addresses

Primary practice location

10945 State Bridge Rd
Alpharetta, GA 30022-8164

Mailing address

330 River Walk Ter
Suwanee, GA 30024-1521
Phone (404) 667-4885

Other identifiers 1

IdentifierTypeStateIssuer
1528083201MedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kare.kim@stores.kroger.com Direct

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

State licenses

LicenseStateTypeSpecialty
RPH22139GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1598363244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 RIVER WALK TER",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241521",
            "telephone_number": "404-667-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10945 STATE BRIDGE RD",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300228164",
            "telephone_number": "770-751-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KAREN",
        "middle_name": "YOON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-14",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH22139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528083201",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kare.kim@stores.kroger.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10945 State Bridge Rd",
            "city": "Alpharetta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300228164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.