Gloria S. Kim, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

LG-0000396 Issued in DE

Practice address

4735 Ogletown Stanton Rd Ste 1250
Newark, DE 19713

Phone

(302) 623-0200

Fax

(302) 623-0117

NPI assigned

Dec 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Vascular Specialists, P.a.

  • Vascular Surgery Physician
  • Newark, DE
  • NPI 1366716060
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1740348986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DR STE 2300",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 OGLETOWN STANTON RD STE 1250",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19713",
            "telephone_number": "302-623-0200",
            "fax_number": "302-623-0117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1941 Limestone Road",
            "address_2": "Suite 211",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198085400",
            "country_code": "US",
            "telephone_number": "302-998-1151",
            "fax_number": "302-998-1154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "GLORIA",
        "middle_name": "S.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DE",
            "license": "L1-0020432",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0000396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740348986",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "162440",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ann Kim, MD
• David Kim, MD
• Diana H Kim, MD
• Eunlim Kim
• Gina S Kim, M.D.
• Isabella Hye Eun Kim
• Jeeyong Charlie Kim, M.D.
• Jemma Jihyun Kim, PT, DPT
• Jung Yae Kim, ANP
• Kyo A Kim, M.D.

• Family Nurse Practitioner in Newark, DE
• Providers in Newark, DE by specialty
• Family Nurse Practitioner in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; 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.