Mira Kim, ARNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

53-74979-072 Issued in KS

Practice address

720 1St Ter
Lansing, KS 66043-1704

Phone

(913) 682-5588

Fax

(913) 682-2698

NPI assigned

Oct 13, 2009

Sex

Female

Sole proprietor

No

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.

• Leavenworth Family Health Center

  • Family Medicine Physician
  • Lansing, KS
  • NPI 1255446480

  KS

  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prime Healthcare Services - Saint John Leavenworth, LLC

  • General Acute Care Hospital
  • Leavenworth, KS
  • NPI 1568705267

  Hospital

  Care Compare affiliation
• Prime Healthcare Services-Providence, LLC

  • General Acute Care Hospital
  • Kansas City, KS
  • NPI 1528301900

  Hospital

  Care Compare affiliation

Specialty

Nurse Practitioner

Education

University of Kansas School of Med (KC/Wich/Sal), 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Leavenworth Family Health Center 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint John Hospital Hospital, Leavenworth, KS, CCN 170009
• Providence Medical Center Hospital, Kansas City, KS, CCN 170146

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 13, 2009.

{
    "created_epoch": "1255392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255392000000",
    "number": "1710212477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12413 W 100TH PL",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662151929",
            "telephone_number": "913-492-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 1ST TER",
            "city": "LANSING",
            "state": "KS",
            "postal_code": "660431704",
            "telephone_number": "913-682-5588",
            "fax_number": "913-682-2698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MIRA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-13",
        "last_updated": "2009-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KS",
            "license": "53-74979-072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garret Logan Kahle, MD
• Kansas City Sports Medicine Inc
• Stephanie Lynn Karleskint, PT, DPT
• Jacquelyn S Kemmerer, DNP
• De'Anna Maxine Kerr, PTA
• Brian W Klamm, PT
• Jacob Kloth, DPT
• Shayla Leann Kramer, P.T.
• Sarah Elizabeth Kukesh, PT, DPT
• Jason S Langford, MPT

• All providers in Lansing, KS
• Adult Health Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.