Individual provider Active NPI

Jinsook Kwack, FNP

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1740721869
Registry record updated Jun 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95005934 Issued in AZ
Practice address
2121 N 44TH St
Phoenix, AZ 85008-3224
Phone
(520) 637-3237
NPI assigned
Mar 9, 2017
Last updated
Jun 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95005934 AZ Primary

Addresses

Primary practice location

2121 N 44TH St
Phoenix, AZ 85008-3224

Mailing address

2121 N 44TH St
Phoenix, AZ 85008-3224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201204001050 CA Practitioner - Nurse Practitioner 0345651881 Reassigns benefits to 2 organizations
I20241003001081 AZ Practitioner - Nurse Practitioner 0345651881 Reassigns benefits to 7 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95005943CAMDNurse Practitioner
95005934CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Diabetes Center, LLC CurrentSince Oct 1, 2025 Accepting new patients
Signify Health Medical Associates of California, PC CurrentSince Aug 23, 2024 Accepting new patients
I Am Wellness Az LLC CurrentSince Oct 1, 2025 Accepting new patients
Bmi423I CurrentSince Oct 1, 2025 Accepting new patients
Mobileonedocs, LLC CurrentSince Sep 1, 2024 Accepting new patients
Signify Health, LLC CurrentSince Aug 23, 2024 Accepting new patients
Mobileonedocs, LLC Family CurrentSince Sep 1, 2024 Accepting new patients
Progressive Pain Management Inc CurrentSince Oct 1, 2025 Accepting new patients
Michael F Esber DPM PC CurrentSince Oct 1, 2025 Accepting new patients
Arizona Essential Wellness PLLC Family Current Accepting new patients
New Vida Medical LLC PastSince Nov 3, 2024 Accepting new patients
Ghods Inc Past Accepting new patients

Locations

1653 E McMurray Blvd
Ste 144
Casa Grande, AZ 85122
Phone (520) 836-8644

2705 S Alma School Rd
Chandler, AZ 85286
Phone (480) 820-7246

3048 E Baseline Rd
Ste 122
Mesa, AZ 85204
Phone (480) 497-5933

535 E McKellips Rd
Ste 111
Mesa, AZ 85203
Phone (480) 223-1333

1616 E Indian School Rd
Ste 135
Phoenix, AZ 85016
Phone (480) 900-9355

202 E Earll Dr
Ste 360
Phoenix, AZ 85012
Phone (480) 323-6072

5060 N 19th Ave
Ste 317
Phoenix, AZ 85015
Phone (602) 904-0088

6707 N 19th Ave
Ste 109
Phoenix, AZ 85015
Phone (602) 371-0188

9150 W Indian School Rd
Ste 118
Phoenix, AZ 85037
Phone (623) 247-5700

10115 E Bell Rd
Ste 107234
Scottsdale, AZ 85260
Phone (480) 843-9877

14418 W Meeker Blvd
Ste 205
Sun City West, AZ 85375
Phone (623) 546-4930

818 W 7th St
Ste 930
Los Angeles, CA 90017
Phone (800) 525-9202

505 Montgomery St
Fl 10
San Francisco, CA 94111
Phone (503) 427-8095

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781395200000",
    "number": "1740721869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 N 44TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850083224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 N 44TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850083224",
            "telephone_number": "520-637-3237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWACK",
        "first_name": "JINSOOK",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-09",
        "last_updated": "2026-06-14",
        "certification_date": "2026-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "95005934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.