Active NPI
Jin-Ju Kim, MD
- Student in an Organized Health Care Education/Training Program
- Falls Church, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 0116035365
- 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, 2021
- 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 |
|---|---|---|---|---|
| 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, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0116035365 | VA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inova Health Care Services | Current | Accepting new patients | |
| Inova Health Care Services | Current | 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
- 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.
-
dba Inova Blood Donor Services
- Medical Technologist
- Sterling, VA
- NPI 1699655589
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Inova Fairfax Hospital
- Rehabilitation Hospital Unit
- Falls Church, VA
- NPI 1588795462
-
dba Inova Fairfax Hospital
- General Acute Care Hospital
- Falls Church, VA
- NPI 1831220714
-
dba Inova Mount Vernon Hospital
- General Acute Care Hospital
- Alexandria, VA
- NPI 1922139120
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.