Individual provider Active NPI

Alena Youngji Kim, PHARMD

  • Pharmacist
  • MC Lean, VA
National Provider Identifier
1639723356
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202217977 Issued in VA
Practice address
1454 Chain Bridge Rd
MC Lean, VA 22101-3706
Phone
(703) 893-8593
NPI assigned
Jul 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202217977 VA Primary

Addresses

Primary practice location

1454 Chain Bridge Rd
MC Lean, VA 22101-3706

Mailing address

5001 Libbile Mill E Blvd Apt 461
Richmond, VA 23230
Phone (571) 484-2854

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
0202217977VAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Eckerd Corporation PastSince Aug 1, 2019 Accepting new patients
Eckerd Corporation PastSince Aug 1, 2019 Accepting new patients
Giant of Maryland LLC PastSince Sep 24, 2023 Accepting new patients
Giant of Maryland LLC PastSince Sep 24, 2023 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1639723356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 LIBBILE MILL E BLVD APT 461",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23230",
            "telephone_number": "571-484-2854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1454 CHAIN BRIDGE RD",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013706",
            "telephone_number": "703-893-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ALENA",
        "middle_name": "YOUNGJI",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202217977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Lean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.