Chang Sook Kim, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95031133 Issued in CA

Practice address

912 Fremont St
Delano, CA 93215-2713

Phone

(866) 707-6664

NPI assigned

Feb 15, 2024

Last updated

Oct 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Omni Family HealthGroup PAC ID 9234176363, 93 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: chang.sookkim.p1@direct.omnifamilyhealth.nextgenshare.com

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.

• Omni Family Health

  • Federally Qualified Health Center (FQHC)
  • Buttonwillow, CA
  • NPI 1700891660
  Medicare reassignment Care Compare group NPD
• Omni Family Health

  • Federally Qualified Health Center (FQHC)
  • Fresno, CA
  • NPI 1205367646
  NPD
• Omni Family Health

  • Federally Qualified Health Center (FQHC)
  • Bakersfield, CA
  • NPI 1770399669
  NPD
• Omni Family Health

  • Federally Qualified Health Center (FQHC)
  • Reedley, CA
  • NPI 1245777358
  NPD (past)
• Omni Family Health

  • Federally Qualified Health Center (FQHC)
  • Delano, CA
  • NPI 1417962457
  NPD (past)

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

{
    "created_epoch": "1707955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1992560304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11825 CAMPUS PARK DR",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933118656",
            "telephone_number": "661-490-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 FREMONT ST",
            "city": "DELANO",
            "state": "CA",
            "postal_code": "932152713",
            "telephone_number": "866-707-6664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHANG SOOK",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-15",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95031133",
            "primary": true
        },
        {
            "code": "163WN0300X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nephrology",
            "state": "CA",
            "license": "95177417",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shubdeep Kaur, DMD
• Kelly & Scott's Care Home Inc.
• Kern Radiology Medical Group
• Dina Khoury
• Brian Songsu Kim, D.M.D.
• Hee Yeong Kim
• Lauren Heajin Kim, PHARM.D
• Taegun Kim, PHARM.D.
• Yuliya Kim
• Mark Alan Kirklin

• Family Nurse Practitioner in Delano, CA
• Providers in Delano, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.
• 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.

Verify at the official NPI Registry.