Active NPI
Jeanie Kim, NP
- Adult Health Nurse Practitioner
- Rochester, NY
National Provider Identifier
1932454303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 301924
- Practice address
- 68 Brittany Cir
Rochester, NY 14618-5632 - Phone
- (703) 344-5555
- NPI assigned
- Jul 20, 2012
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 301924 | NY | Primary |
Addresses
Primary practice location
68 Brittany Cir
Rochester, NY 14618-5632
Mailing address
68 Brittany Cir
Rochester, NY 14618-5632
Phone (703) 344-5555
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 301924 | NY | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342742400000",
"number": "1932454303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "68 BRITTANY CIR",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146185632",
"telephone_number": "703-344-5555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "68 BRITTANY CIR",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146185632",
"telephone_number": "703-344-5555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JEANIE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-20",
"last_updated": "2012-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "301924",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.