Kelly H. C. Kim, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0001199919 Issued in VA

Practice address

1708 Old Donation Pkwy
Virginia Beach, VA 23454-3064

Phone

(757) 395-5300

NPI assigned

Oct 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Cardiovascular Assoc LTD

  • Cardiovascular Disease Physician
  • Virginia Beach, VA
  • NPI 1023062825
  NPD (past)
• Cardiovascular Associates LTD

  • Cardiovascular Disease Physician
  • Chesapeake, VA
  • NPI 1114971918
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912089244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 CLEVELAND ST",
            "address_2": "SUITE 228",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621752",
            "telephone_number": "757-499-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 OLD DONATION PKWY",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543064",
            "telephone_number": "757-395-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KELLY",
        "middle_name": "H. C.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0001199919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE RN LICENSE",
            "identifier": "0001199919",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Ann Killmon, DOULA
• Allison Kim, BCBA
• Hanah Jiae Kim
• Jason Kim, D.D.S.
• Justeen Kim, CCC-SLP
• Kristin Kim, D.D.S.
• Liliana Kim, DNP, FNP-C, PMHNP
• Madison Kim
• Royce Kim, DO
• Trudy Elizabeth Kim, LPC

• Nurse Practitioner in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.