Kyungsun Jeong Kim, PHARM D

Primary specialty

PharmacistTaxonomy code 183500000X

License

58905541701 Issued in UT

Practice address

5353 S 960 E
#103
Salt Lake City, UT 84117-3569

Phone

(801) 288-4013

Fax

(801) 288-2485

NPI assigned

Dec 6, 2011

Last updated

Dec 6, 2011By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1323129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1619245529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5353 S 960 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841173569",
            "telephone_number": "801-288-0413",
            "fax_number": "801-288-2485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 S 960 E",
            "address_2": "#103",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841173569",
            "telephone_number": "801-288-4013",
            "fax_number": "801-288-2485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KYUNGSUN",
        "middle_name": "JEONG",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-06",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "58905541701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UTAH DEPARTMENT OF COMMERCE FOR PHARMACY",
            "identifier": "58905541701",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaehwan Kim
• Jessica S. Kim, MD
• Jin Young Kim, MD, PHD
• Jong Hun Kim, M.D.
• Kevin Kyehwan Kim
• Paul H. Kim, M.D.
• Rachel Kim
• Rebecca Greaves Kim, M.D.
• Robin Davis Kim, MD
• Serena Kim, ACMHC

• Pharmacist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Pharmacist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; 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.