DR. JODY SOOK KIM (NPI# 1114133642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114133642 |
| Entity Type | Individual |
| Full Name | DR. JODY SOOK KIM |
| Credential | L.AC.,OMD |
| Practice Address |
706a N Reilly Rd Fayetteville NC 28303-5619 |
| Practice Telephone | 9108688865 |
| Mailing Telephone | 9108688865 |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2019-03-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171100000X | Acupuncturist | 1053 | NC | Other Service Providers |
| N | 171100000X | Acupuncturist | 7596 | CA | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 521 W Channel Islands Blvd, Ste 6, Port Hueneme, CA 930412132 | 8058150333 |
| Street Address |
706A N REILLY RD |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28303-5619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346573847 | Kevin Daesu Shin | Acupuncturist | 706a N Reilly Rd, Fayetteville, NC 28303-5619 | 2009-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801404496 | Matthew Pace | Physician Assistant | Bldg 5-4257 Bastogne St, Fort Bragg, NC 28303 | 2020-07-20 |
| 1952920449 | Vonetta Bethea Jackson | Social Worker | 391 Wagoner Drive, Fayetteville, NC 28303 | 2020-04-14 |
| 1932746229 | Julie Harriss | Specialist/Technologist | Bldg E 4062, Canopy Lane, Fort Bragg, NC 28303 | 2019-12-05 |
| 1235780354 | Helen Delores Johnson | Technician | 261 Pierron Dr, Fayetteville, NC 28303 | 2019-09-20 |
| 1922655075 | Andrea Margaret Hutnam | Technician | 714 Shortridge Rd, Fayetteville, NC 28303 | 2019-08-23 |
| 1225695273 | Breona Lister | Dental Hygienist | 38 17 Gruber Rd, Fort Bragg, NC 28303 | 2019-05-24 |
| 1780148957 | Brian K Cox Sr. | Occupational Therapy Assistant | 5300 Ramsey St, Fayetteville, NC 28303 | 2019-01-22 |
| 1730670902 | Michael Sadtler | Counselor | 804 Stamper Rd Ste 101, Fayetteville, NC 28303 | 2018-05-23 |
| 1104320399 | Tia Porterfield | Counselor | 2018 Fort Bragg Rd Ste 112a, Fayetteville, NC 28303 | 2018-03-21 |
| 1154835577 | Jessica Bass Bosworth | Psychologist | 3415 Youngstown Dr, Fayetteville, NC 28303 | 2017-11-21 |
| Find all providers in zip 28303 | ||||
| Taxonomy Code | 171100000X |
| Grouping | Other Service Providers |
| Classification | Acupuncturist |
| An acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699317727 | Melody Ry | Acupuncturist | 1792 E Joyce Blvd Ste 5, Fayetteville, AR 72703-5255 | 2019-10-10 |
| 1760835177 | Nadine Alonzo | Acupuncturist | 4315 Norwick Dr, Fayetteville, NC 28314-2531 | 2016-07-20 |
| 1972982395 | Zach Beavers | Acupuncturist | 130 N College Ave, Suite D, Fayetteville, AR 72701-5311 | 2015-05-19 |
| 1013332519 | Kum Ja Song | Acupuncturist | 201 N Reilly Rd, Fayetteville, NC 28303-2410 | 2014-02-20 |
| 1245502921 | Jana Lynn Brady | Acupuncturist | 207 N College Ave, Fayetteville, AR 72701-4238 | 2012-01-27 |
| 1093038713 | Hui Sun Gallop | Acupuncturist | 7709 Cliffdale Rd, Fayetteville, NC 28314-5841 | 2010-03-09 |
| 1205077914 | Ho Young Choi | Acupuncturist | 874 Strickland Bridge Rd, Fayetteville, NC 28304-2799 | 2009-03-11 |
| 1952553745 | Laura Jane Adams | Acupuncturist | 1638 Owen Dr # 138, Fayetteville, NC 28304 | 2008-10-13 |
| 1679612865 | Phyllis Hayya Knopf | Acupuncturist | 216 W South St, Fayetteville, AR 72701-5959 | 2007-02-05 |
| 1659916823 | Katherine Mary Barton | Acupuncturist | 1792 E Joyce Blvd Ste 5, Fayetteville, AR 72703-5255 | 2019-11-12 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28303 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.