Active NPI
Jennifer L Kim, ARNP
- Family Nurse Practitioner
- Seattle, WA
National Provider Identifier
1801458922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP60974100
- Practice address
- 1660 S Columbian Way
Ms S-123 PCC
Seattle, WA 98108-1532 - Phone
- (206) 762-1010
- NPI assigned
- Jun 28, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP60974100 | WA | Primary |
Addresses
Primary practice location
1660 S Columbian Way
Ms S-123 PCC
Seattle, WA 98108-1532
Mailing address
1660 S Columbian Way
Ms S-123 PCC
Seattle, WA 98108-1532
Phone (206) 762-1010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210219001575 | WA | Order and Referring Only - Nurse Practitioner | 8628483864 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP60974100 | WA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561680000000",
"number": "1801458922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1660 S COLUMBIAN WAY",
"address_2": "MS S-123 PCC",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981081532",
"telephone_number": "206-762-1010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1660 S COLUMBIAN WAY",
"address_2": "MS S-123 PCC",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981081532",
"telephone_number": "206-762-1010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JENNIFER",
"middle_name": "L",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-28",
"last_updated": "2019-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "AP60974100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.