Janice Chin Sun Kim, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP17755 Issued in CA

Practice address

4199 Flat Rock Dr Ste 147
Riverside, CA 92505-7115

Phone

(951) 760-6209

Fax

(833) 694-1500

NPI assigned

Nov 8, 2007

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 names 1

• Janice Chin Sun Kim Professional name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: janice.kimnp.p13@direct.pca.nextgenshare.com

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.

• Pacific Cardiovascular Associates Medical Group, Inc.

  • Legal Medicine
  • Costa Mesa, CA
  • NPI 1700821691
  Medicare reassignment NPD
• Vitality Ageless Center LLC

  • Multi-Specialty Clinic/Center
  • Suwanee, GA
  • NPI 1730657271

  CA

  Medicare reassignment NPD
• Cal Sport Physical Medicine Inc

  • Internal Medicine Physician
  • Oakdale, CA
  • NPI 1952868218
  NPD
• Eric Walsh & Associates, a Medical Corporation

  • Clinic/Center
  • Riverside, CA
  • NPI 1427824796
  NPD

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1952581738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4199 FLAT ROCK DR STE 147",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925057115",
            "telephone_number": "951-760-6209",
            "fax_number": "833-694-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4199 FLAT ROCK DR STE 147",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925057115",
            "telephone_number": "951-760-6209",
            "fax_number": "833-694-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JANICE",
        "middle_name": "CHIN SUN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-08",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP17755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANICE",
            "last_name": "KIM",
            "middle_name": "CHIN SUN",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Hyung Koo Kim, M.D.
• Il Nam Kim, L.AC.
• Jaedeok Kim, LAC, PHD.
• James S Kim, DDS
• James S. Kim, M.D
• Jennifer Kim, MD
• Jeong Doo Kim, M.D, D.D.S
• Ji Young Kim, DMD, MS
• Joanne Kim, NP
• Jonathan Kiltai Kim, M.D.

• Nurse Practitioner in Riverside, CA
• Providers in Riverside, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.