Active NPI
Yei Jin Kim
- Pharmacist
- Fairfax, VA
National Provider Identifier
1770185878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202214212
- Practice address
- 13043 Lee Jackson Memorial Hwy
Fairfax, VA 22033-2001 - Phone
- (703) 968-9293
- NPI assigned
- Nov 12, 2020
- Last updated
- Nov 12, 2020
- Sex
- Female
- 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 | 0202214212 | VA | Primary |
Addresses
Primary practice location
13043 Lee Jackson Memorial Hwy
Fairfax, VA 22033-2001
Mailing address
13043 Lee Jackson Memorial Hwy
Fairfax, VA 22033-2001
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202214212 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Giant of Maryland LLC | Past | Accepting new patients | |
| Giant of Maryland LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605139200000",
"number": "1770185878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13043 LEE JACKSON MEMORIAL HWY",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220332001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13043 LEE JACKSON MEMORIAL HWY",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220332001",
"telephone_number": "703-968-9293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "YEI JIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-12",
"last_updated": "2020-11-12",
"certification_date": "2020-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202214212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.