Individual provider Active NPI

Jungok Kim

  • Certified Registered Nurse Anesthetist
  • Falls Church, VA
National Provider Identifier
1831770767
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024181697 Issued in VA
Practice address
3300 Gallows Rd
Falls Church, VA 22042-3307
Phone
(703) 776-4001
NPI assigned
Apr 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Certified Registered Nurse Anesthetist 367500000X 0024181697 VA Primary

Addresses

Primary practice location

3300 Gallows Rd
Falls Church, VA 22042-3307

Mailing address

7911 Lysander CT
MC Lean, VA 22102-2735
Phone (703) 599-2068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, MD3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210715003695 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 9436551207 Reassigns benefits to 4 organizations
I20210908000578 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9436551207 Reassigns benefits to 5 organizations
I20250820002496 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 9436551207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Virginia, LLCGroup PAC ID 6608268826, 407 clinicians
Inova Cares - CommunityGroup PAC ID 9537526330, 187 clinicians
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

2501 Parkers LN
Alexandria, VA 22306-3209
Phone (703) 664-7000

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-4001

3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Phone (703) 391-3600

44045 Rivderside Pkwy
Leesburg, VA 20176-5101
Phone (703) 858-6000

9000 Franklin Square Dr
Baltimore, MD 21237-3901
Phone (443) 777-7000

Hospital & facility affiliations

  • Medstar Franklin Square Medical Center Hospital, Rosedale, MD, CCN 210015
  • Inova Loudoun Hospital Hospital, Leesburg, VA, CCN 490043
  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Virginia, PC CurrentSince Jun 1, 2021 Accepting new patients
Mary Washington Healthcare Specialty Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2025 Accepting new patients
American Anesthesiology of Virginia PC CurrentSince Jun 1, 2021 Accepting new patients
Northstar Anesthesia of Virginia, LLC CurrentSince Jun 6, 2023 Accepting new patients
Medstar Medical Group II LLC CurrentSince Aug 1, 2025 Accepting new patients
Old Dominion Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 6, 2024 Accepting new patients
Inova Cares - Community CurrentSince Feb 10, 2025 Accepting new patients
Medstar Medical Group II LLC CurrentSince Aug 1, 2025 Accepting new patients

Locations

3007 Tilden St NW
Ste 5N
Washington, DC 20008

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

9000 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 682-7000

1800 N Beauregard St
Ste 200
Alexandria, VA 22311
Phone (703) 823-3750

2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000

3914 Centreville Rd
Ste 350
Chantilly, VA 20151
Phone (703) 263-3393

1139 E High St
Ste 105
Charlottesvle, VA 22902
Phone (434) 817-8484

736 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6124

541 Sunset Ln
Ste 201
Culpeper, VA 22701
Phone (540) 829-0700

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

1201 Sam Perry Blvd
Ste 101
Fredericksburg, VA 22401
Phone (540) 741-4614

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950

1939 Roland Clarke Pl
Ste 200
Reston, VA 20191
Phone (703) 435-3366

101 Hospital Center Blvd
Stafford, VA 22554
Phone (540) 741-3340

Organizations & group practices 8

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1831770767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7911 LYSANDER CT",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221022735",
            "telephone_number": "703-599-2068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 GALLOWS RD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423307",
            "telephone_number": "703-776-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JUNGOK",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-21",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024181697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.