Active NPI
Yoo Jung Kim, CRNA
- Certified Registered Nurse Anesthetist
- Dallas, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 817179
- Practice address
- 5323 Harry Hines Blvd
Dallas, TX 75390-7201 - Phone
- (214) 648-3111
- NPI assigned
- Jan 12, 2015
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 817179 | TX | Primary |
Addresses
Primary practice location
5323 Harry Hines Blvd
Dallas, TX 75390-7201
Mailing address
1825 Thistle Hill Dr
Apt 17101
Fort Worth, TX 76110-7434
Phone (817) 239-3151
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
411 N Lakeview Ave
Anaheim, CA 92807-3028
Phone (714) 279-4000
8741 Alden Dr
Suite C
Los Angeles, CA 90048-3692
Phone (323) 693-8832
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 817179 | TX | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Glendora Anesthesia Associates LP | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Lightning Anesthesia Nursing Services, P.C. | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
411 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000
5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088
5562 Philadelphia St
Ste 111
Chino, CA 91710
Phone (626) 967-0352
1794 S Barranca Ave
Glendora, CA 91740
Phone (626) 858-4600
5 Holland
Ste 101
Irvine, CA 92618
Phone (949) 588-2199
4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784
4760 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 783-0567
4867 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 783-7920
393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914
558 Saint Charles Dr
Ste 200
Thousand Oaks, CA 91360
Phone (805) 379-2322
696 Hampshire Rd
Ste 160
Westlake Vlg, CA 91361
Phone (805) 494-3377
Organizations & group practices 6
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.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Certified Registered Nurse Anesthetist
- Glendora, CA
- NPI 1750748331
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Monterey Park, CA
- NPI 1710672316
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Chino, CA
- NPI 1356108831
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Fullerton, CA
- NPI 1336556059
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638403200000",
"number": "1881083103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1825 THISTLE HILL DR",
"address_2": "APT 17101",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761107434",
"telephone_number": "817-239-3151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5323 HARRY HINES BLVD",
"city": "DALLAS",
"state": "TX",
"postal_code": "753907201",
"telephone_number": "214-648-3111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "YOO",
"middle_name": "JUNG",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-12",
"last_updated": "2021-12-02",
"certification_date": "2021-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TX",
"license": "817179",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "4760 W Sunset Blvd",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900276063",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; 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.