Active NPI
NA-Young Kim
- Pharmacist
- Manassas, VA
National Provider Identifier
1962799866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202210259
- Practice address
- 8340 Sudley Rd
Manassas, VA 20109-3428 - Phone
- (703) 392-3634
- Fax
- (703) 392-3634
- NPI assigned
- Jun 30, 2011
- Last updated
- Aug 12, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202210259 | VA | Primary |
Addresses
Primary practice location
8340 Sudley Rd
Manassas, VA 20109-3428
Mailing address
8340 Sudley Rd
Manassas, VA 20109-3428
Phone (703) 392-3634
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202210259 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Carolina CVS Pharmacy LLC | Past | Accepting new patients | |
| Target Corporation | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313107200000",
"number": "1962799866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8340 SUDLEY RD",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201093428",
"telephone_number": "703-392-3634",
"fax_number": "703-392-3634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8340 SUDLEY RD",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201093428",
"telephone_number": "703-392-3634",
"fax_number": "703-392-3634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "NA-YOUNG",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-30",
"last_updated": "2011-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202210259",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manassas, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.