Active NPI
Jeesu Kim
- Pharmacist
- Belmont, MA
National Provider Identifier
1922836238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH997306
- Practice address
- 89 Leonard St
Belmont, MA 02478-2511 - Phone
- (617) 489-3669
- NPI assigned
- Jul 26, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH997306 | MA | Primary |
Addresses
Primary practice location
89 Leonard St
Belmont, MA 02478-2511
Mailing address
89 Leonard St
Pharmacy
Belmont, MA 02478
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH997306 | MA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Current | Accepting new patients | |
| CVS Pharmacy Inc | Past | Accepting new patients |
Locations
89 Leonard St
Belmont, MA 02478
Phone (617) 489-3669
Organizations & group practices 2
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.
-
- Pharmacy
- Belmont, MA
- NPI 1699874040
-
- Pharmacy
- Stafford, TX
- NPI 1427931351
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721952000000",
"number": "1922836238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "89 LEONARD ST",
"address_2": "PHARMACY",
"city": "BELMONT",
"state": "MA",
"postal_code": "02478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "89 LEONARD ST",
"city": "BELMONT",
"state": "MA",
"postal_code": "024782511",
"telephone_number": "617-489-3669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JEESU",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-26",
"last_updated": "2024-07-26",
"certification_date": "2024-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH997306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belmont, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.