JOHN KIM (NPI# 1114423183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114423183 |
| Entity Type | Individual |
| Full Name | JOHN KIM |
| Practice Address |
4201 Saint Antoine St # 9c Detroit MI 48201-2153 |
| Practice Telephone | 3139660463 |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2018-03-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255942132 | John Minsung Kim | Acupuncturist | 2 N 6th Pl Apt 6n, Brooklyn, NY 11249-3397 | 2020-08-13 |
| 1437711207 | John Kim | Dentist | 21 White Bridge Rd Ste 111, Nashville, TN 37205-1443 | 2019-07-02 |
| 1306316039 | John S Kim | Technician | 217 N 21st St, Las Vegas, NV 89101-4503 | 2018-11-26 |
| 1821441551 | John H Kim | Registered Nurse | 12140 Monument Dr Unit 464, Fairfax, VA 22033-5518 | 2016-07-18 |
| 1912351941 | John Hyun-suk Kim | Dentist | 901 Moraga Rd Ste B, Lafayette, CA 94549-4567 | 2016-04-15 |
| 1831556117 | John Kim | Dentist | 10011 Bridgeport Way Sw, Ste 700, Lakewood, WA 98499-2332 | 2016-01-18 |
| 1184968703 | John J Kim | Acupuncturist | 20331 Allport Ln, Huntington Beach, CA 92646-5101 | 2012-11-20 |
| 1699039792 | John Minkyu Kim | Dentist | 618th Dental Co. Usag Humphreys, Carius Dental Clinic, Unit # 15660, Bldg # P3020, Apo, AP 96271-5660 | 2012-07-03 |
| 1598032559 | John Hakkyun Kim | Family Medicine | 3195 Harbor Blvd Ste 3, Costa Mesa, CA 92626-2514 | 2011-11-18 |
| 1811279722 | John Hoon Chul Kim | Pharmacist | 101 Pointe Dr, Unit 102, Northbrook, IL 60062-1001 | 2011-09-16 |
| Street Address |
4201 SAINT ANTOINE ST # 9C |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396086286 | Nathan Vandjelovic | Otolaryngology | 4201 Saint Antoine St # 9c, Detroit, MI 48201-2153 | 2013-03-03 |
| 1609499193 | Fred Henry Daniel Charles | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St # 9c, Detroit, MI 48201-2153 | 2020-05-19 |
| 1215559059 | Aws Polina | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St # 9c, Detroit, MI 48201-2153 | 2020-05-14 |
| 1922620954 | Anika Pewlee | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St # 9c, Detroit, MI 48201-2153 | 2020-05-13 |
| 1639791916 | Lawrence Tyng-hann Chen | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St # 9c, Detroit, MI 48201-2153 | 2020-05-10 |
| 1720600265 | Alix Charles Jr. | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St # 9c, Detroit, MI 48201-2153 | 2020-05-07 |
| 1558982504 | Amy Capone | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St # 9c, Detroit, MI 48201-2153 | 2020-04-30 |
| 1417578626 | Alissa Anne Moody | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St # 9c, Detroit, MI 48201-2153 | 2020-04-28 |
| 1194346429 | John-ezekiel Sengco Dayco | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St # 9c, Detroit, MI 48201-2153 | 2020-04-28 |
| 1720609001 | Chibuzo Casey Ohanaja | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St # 9c, Detroit, MI 48201-2153 | 2020-04-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013514702 | Leeza Fortner | Student in an Organized Health Care Education/Training Program | 259 Mack Ave Ste 4514, Detroit, MI 48201-2427 | 2020-10-06 |
| 1174132583 | Odei Alayyas | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Boulevard Henry Ford Hospital, Medical Ed, Detroit, MI 48202 | 2020-07-31 |
| 1912516790 | Omar Choudhury | Student in an Organized Health Care Education/Training Program | Henroy Ford Hospital, Medical Education Department ., 2799 W. Grand Boulevard, Detroit, MI 48202-2608 | 2020-07-28 |
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1932725959 | Devonn Eli Israil | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St Rm 2d, Detroit, MI 48201-2153 | 2020-06-25 |
| 1457976292 | Ali Nauman Khan | Student in an Organized Health Care Education/Training Program | Detroit Medical Center-sinai Grace Hospital, 6071 W. Outer Driver, Detroit, MI 48235 | 2020-06-08 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
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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.