Kimberly Ju Kim, M.D., M.P.H.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

046884 Issued in CT

Practice address

820 C Prospect Hill Road
Windsor, CT 06095

Phone

(860) 285-8251

Fax

(860) 687-1774

NPI assigned

Dec 27, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kimberly.kim@pedicorp.eclinicaldirectplus.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.

• Pedicorp, PC

  • Pediatric Adolescent Medicine Physician
  • West Hartford, CT
  • NPI 1952581928
  NPD (past)

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1962686824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 C PROSPECT HILL ROAD",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "06095",
            "telephone_number": "860-285-8251",
            "fax_number": "860-687-1774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 C PROSPECT HILL ROAD",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "06095",
            "telephone_number": "860-285-8251",
            "fax_number": "860-687-1774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KIMBERLY",
        "middle_name": "JU",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-27",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CT",
            "license": "046884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Lynn Kemp
• Kendall Buraimoh Physiatry
• Taiham Tauseef Khan
• Yusra Irfan Khan
• Christina M Kiley
• Myunggyo Kim, LPCA
• Kimberly Hall South
• Kindred Konnections, LLC
• Alexis Marleen Kinney
• Evelyn Kirby

• Pediatric Adolescent Medicine Physician in Windsor, CT
• Providers in Windsor, CT by specialty
• Pediatric Adolescent Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.