Active NPI
Pamela Jiehyun Kim, R.D.
- Registered Dietitian
- New York, NY
National Provider Identifier
1841592060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 007040
- Practice address
- 2 Gold St Apt 2803
New York, NY 10038-4855 - Phone
- (347) 410-3244
- NPI assigned
- Nov 19, 2010
- Last updated
- Nov 19, 2010
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 007040 | NY | Primary |
Addresses
Primary practice location
2 Gold St Apt 2803
New York, NY 10038-4855
Mailing address
2 Gold St Apt 2803
New York, NY 10038-4855
Phone (347) 410-3244
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007040 | NY | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sound Shore Physician Services | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinic/Center
- New Rochelle, NY
- NPI 1689883068
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290124800000",
"number": "1841592060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 GOLD ST APT 2803",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100384855",
"telephone_number": "347-410-3244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 GOLD ST APT 2803",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100384855",
"telephone_number": "347-410-3244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "PAMELA",
"middle_name": "JIEHYUN",
"name_prefix": "Ms.",
"credential": "R.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-19",
"last_updated": "2010-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "007040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.