Active NPI
Ho Mike Kim, RPH
- Pharmacist
- Sandy, UT
National Provider Identifier
1710496989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 153175-1701
- Practice address
- 11100 S Auto Mall Dr
Sandy, UT 84070-4171 - Phone
- (801) 790-0002
- NPI assigned
- Sep 20, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 | 153175-1701 | UT | Primary |
Addresses
Primary practice location
11100 S Auto Mall Dr
Sandy, UT 84070-4171
Mailing address
11774 S Twin Pines CT
Draper, UT 84020-4519
Phone (801) 450-1370
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 |
|---|---|---|---|
| 153175-1701 | UT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505865600000",
"number": "1710496989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11774 S TWIN PINES CT",
"city": "DRAPER",
"state": "UT",
"postal_code": "840204519",
"telephone_number": "801-450-1370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11100 S AUTO MALL DR",
"city": "SANDY",
"state": "UT",
"postal_code": "840704171",
"telephone_number": "801-790-0002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "HO",
"middle_name": "MIKE",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-09-20",
"last_updated": "2017-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "UT",
"license": "153175-1701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandy, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.