Jessica Kim, N.P.

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

21602 Issued in CA

Practice address

9040 Jackson Ave
Tacoma, WA 98431-3186

Phone

(253) 968-1110

NPI assigned

Apr 12, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• East Valley Community Health Center, Inc.

  dba East Valley Community Health Center

  • Federally Qualified Health Center (FQHC)
  • West Covina, CA
  • NPI 1831243625
  Medicare reassignment NPD
• East Valley Community Health Center, Inc.

  dba East Valley Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Pomona, CA
  • NPI 1649324443
  NPD

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1871850032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11782",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926585041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984313186",
            "telephone_number": "253-968-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JESSICA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-12",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "21602",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "21602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ha Eun Kim
• Hyung Woo Kim, PHARMD
• Jae Keun Kim, PHARMD
• Jay Won Kim
• Jeffrey Kim
• Jieun Kim, PHARM.D.
• John Paul Kim, MD
• Juhyeon Kim, RN
• Jung Kyung Kim, PHARM D
• Katalina Kim, PNP

• Women's Health Nurse Practitioner in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Women's Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.

Verify at the official NPI Registry.