Individual provider Active NPI

Jin-Ju Kim, MD

  • Student in an Organized Health Care Education/Training Program
  • Falls Church, VA
National Provider Identifier
1932770294
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
0116035365 Issued in VA
Practice address
Inova Fairfax Medical Campus Gme Department of Medicine
3300 Gallows Road
Falls Church, VA 22042
Phone
(703) 776-3582
NPI assigned
Jul 8, 2021
Last updated
Jul 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 0116035365 VA Primary

Addresses

Primary practice location

Inova Fairfax Medical Campus Gme Department of Medicine
3300 Gallows Road
Falls Church, VA 22042

Mailing address

Inova Fairfax Medical Campus Gme Department of Medicine
3300 Gallows Road
Falls Church, VA 22042
Phone (703) 776-3582

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240913000765 DC Practitioner - HospitalistPractitioner - Internal Medicine 9830639137 Reassigns benefits to 1 organization
I20240926002103 VA Practitioner - HospitalistPractitioner - Internal Medicine 9830639137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

3300 Gallows Rd
Falls Church, VA 22042-3307

44045 Rivderside Pkwy
Leesburg, VA 20176-5101
Phone (703) 771-2960

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0116035365VAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Aug 18, 2024 Accepting new patients
Inova Health Care Services CurrentSince Aug 18, 2024 Accepting new patients

Locations

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

3300 Gallows Rd
Fl 1
Falls Church, VA 22042
Phone (703) 776-4005

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

Interoperability endpoints

  • Direct secure messaging: jkim899378@soc.inova.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1932770294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "INOVA FAIRFAX MEDICAL CAMPUS GME DEPARTMENT OF MEDICINE",
            "address_2": "3300 GALLOWS ROAD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "22042",
            "telephone_number": "703-776-3582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "INOVA FAIRFAX MEDICAL CAMPUS GME DEPARTMENT OF MEDICINE",
            "address_2": "3300 GALLOWS ROAD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "22042",
            "telephone_number": "703-776-3582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JIN-JU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-08",
        "last_updated": "2021-07-08",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116035365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

Verify at the official NPI Registry.