Christine Kim, NP-C
Individual provider Active NPI Nurse Practitioner · Port Monmouth, NJ
NPI 1629313879 · NPPES record last updated Jul 23, 2019
Key facts
- NPI
- 1629313879
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 26NR14289800 (NJ)
- Practice address
- 15 Pinehurst Ave
Port Monmouth, NJ 07758-1427 - Phone
- (848) 218-1356
- NPI assigned
- Nov 29, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121213000295 | NJ | Practitioner - Nurse Practitioner | 1557513850 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NR14289800 | NJ | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Immediate Care Medical Walk-in of Hazlet, PA | Current |
Accepting new patients | |
| Urgent Care Physicians of New Jersey, LLC | Current |
Accepting new patients | |
| Charles L. Spellman, DO | Past | Accepting new patients | |
| Hospital Medicine of Monmouth County | Past | Accepting new patients |
Locations
319 US Highway 130
East Windsor, NJ 08520
Phone (609) 426-4300
1376 State Route 36
Hazlet, NJ 07730
Phone (732) 264-5500
46 Newman Springs Rd E
Ste F
Red Bank, NJ 07701
Phone (732) 933-4100
1 Route 37 W
Toms River, NJ 08753
Phone (732) 281-3201
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 26NR14289800 | NJ | Yes |
Addresses
Primary practice location
15 Pinehurst Ave
Port Monmouth, NJ 07758-1427
Mailing address
17 Cheyenne St
Tinton Falls, NJ 07712-7753
Phone (848) 218-1356
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 26NJ00402500 | Other | NJ | ADVANCED PRACTICE NURSE LICENSE NUMBER |
Other names
- Christine Brewer
Other providers in Port Monmouth, NJ
- Home Stretch Consulting, LLC
- Horizon Mental Wellness LLC
- Christine Ibrahim
- Yasmeen Jafry
- Christopher Johnston
- Tracey A Licciardi
- Ruth Marietta
- Lauren McGinley
- Kristen McGuire
- Minding Miracles
All providers in Port Monmouth, NJ · Nurse Practitioner in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.