Active NPI
Chong Ki Kim, RPH
- Pharmacist
- Camillus, NY
National Provider Identifier
1679800155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 42867
- Practice address
- 5399 W Genesee St
Camillus, NY 13031-2265 - Phone
- (315) 487-6714
- Fax
- (315) 487-0988
- NPI assigned
- Nov 4, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 42867 | NY | Primary |
Addresses
Primary practice location
5399 W Genesee St
Camillus, NY 13031-2265
Mailing address
5147 Burnside Dr
Jamesville, NY 13078-3711
Phone (315) 882-2064
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42867 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257292800000",
"number": "1679800155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5147 BURNSIDE DR",
"city": "JAMESVILLE",
"state": "NY",
"postal_code": "130783711",
"telephone_number": "315-882-2064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5399 W GENESEE ST",
"city": "CAMILLUS",
"state": "NY",
"postal_code": "130312265",
"telephone_number": "315-487-6714",
"fax_number": "315-487-0988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "CHONG KI",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-11-04",
"last_updated": "2009-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "42867",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camillus, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.