JUNG MI KIM (NPI# 1114497351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114497351 |
| Entity Type | Individual |
| Full Name | JUNG MI KIM |
| Practice Address |
24795 Pinebrook Rd Chantilly VA 20152-4239 |
| Mailing Address |
11645 Leehigh Dr Fairfax VA 22030-5641 |
| Practice Telephone | 8663892727 |
| Enumeration Date | 2018-11-30 |
| Last Update Date | 2018-12-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024176496 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 24795 Pinebrook Rd, South Riding, VA 201524239 | 3017872249 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083136659 | Jung E Kim | Speech-Language Pathologist | 37 Summit Ave, Metuchen, NJ 08840 | 2017-07-14 |
| 1215307095 | Jung O. Kim IIi | Nurse Practitioner | 23247 Mcbean Parkway, Valencia, CA 91355 | 2015-10-06 |
| 1528323714 | Jung Kim | Dietitian, Registered | 540 Ashbourne Rd, Cheltenham, PA 19012-1702 | 2012-07-12 |
| 1902163090 | Jung Kyung Kim | Acupuncturist | 2049 P C H Ste 107, Lomita, CA 90717-2661 | 2012-04-13 |
| 1174818496 | Jung H Kim | Dentist | 309a Broad Ave, Palisades Park, NJ 07650-1620 | 2011-06-15 |
| 1104145226 | Jung Il Kim | Acupuncturist | 2315 Marks Dr, Tustin, CA 92782-1500 | 2010-05-28 |
| 1255662896 | Jung S Kim | Acupuncturist | 26 Bellinger Ct., Reisterstown, MD 21136 | 2010-01-21 |
| 1396910733 | Jung Min Kim | Dentist | 4233 Rosewood Dr, 11, Pleasanton, CA 94588 | 2008-04-28 |
| 1134311699 | Jung Hee Kim | Acupuncturist | 2650 W Temple St, Los Angeles, CA 90026-4822 | 2007-08-17 |
| 1235320037 | Jung Sook Kim | Acupuncturist | 7230 Medical Center Dr Ste 400, West Hills, CA 91307-4013 | 2007-08-06 |
| Street Address |
24795 PINEBROOK RD |
| City | CHANTILLY |
| State | VA |
| Zip Code | 20152-4239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528669751 | Joy Chirnside Mclaughlin | Physical Therapist | 26097 Iverson Drive, Chantilly, VA 20152 | 2020-11-04 |
| 1972132090 | Alissa S Rexo | Specialist | 25251 Beach Place, Chantilly, VA 20152 | 2020-04-02 |
| 1982178620 | South Riding Modern Dentistry, PC | Dentist | 25421 Lizzio Center Dr., Suite 190, Chantilly, VA 20152 | 2019-01-16 |
| 1154897627 | Nicole Hong | Dentist | 25273 Nesting Sq, Chantilly, VA 20152 | 2018-10-22 |
| 1437586369 | Chiron Physical Therapy LLC | Physical Therapist | 48130 Amberwood Plaza, Suite 100, South Riding, VA 20152 | 2013-10-10 |
| 1376772178 | Gloria Seon-young Kim | Dentist | 24805 Pinebrook Rd # 311, Chantilly, VA 20152 | 2009-07-14 |
| 1992955777 | Sohaib S. Elsayed | Family Medicine | 25055 Riding Plz Ste 220, South Riding, VA 20152 | 2008-09-29 |
| 1790970556 | Irfan Galaria | Plastic Surgery | 24805 Pinebrook Road, Suite #154, Chantilly, VA 20152 | 2007-09-13 |
| 1316150881 | Dina Gottesman | Pediatrics | 25055 Riding Plaza, Suite 150, South Riding, VA 20152 | 2007-05-08 |
| 1528101805 | Kamran Nawaz Raja | Dentist | 24805 Pinebrook Rd Ste 318, Chantilly, VA 20152 | 2007-02-15 |
| Find all providers in zip 20152 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316560873 | Frontier Integrative Medicine LLC | Nurse Practitioner | 42502 Oxford Forest Cir, Chantilly, VA 20152-5970 | 2020-05-19 |
| 1043761117 | Victoria Ranti Balogun | Nurse Practitioner | 14121 Parke Long Court, Suite 201, Chantilly, VA 20151 | 2016-10-24 |
| 1619424694 | Erin Booker | Nurse Practitioner | Parke Long Court, Suite 201, Chantilly, VA 20151 | 2016-09-07 |
| 1538409305 | Christina Lynda Rosenberg | Nurse Practitioner | 3914 Centreville Rd Ste 250, Chantilly, VA 20151-3290 | 2013-02-15 |
| 1588219778 | Laura Kangha Nyindem | Nurse Practitioner | 24801 Pinebrook Rd Ste 110, Chantilly, VA 20152-4113 | 2019-08-05 |
| 1902379241 | Nadege Ateh | Nurse Practitioner | 24801 Pinebrook Rd Ste 110, Chantilly, VA 20152-4113 | 2019-01-09 |
| 1548742133 | Hena Islam Ahsan | Nurse Practitioner | 14133 Robert Paris Ct, Chantilly, VA 20151-4203 | 2018-08-30 |
| 1609381219 | Ashleigh Jordan Tiller | Nurse Practitioner | 24801 Pinebrook Rd Ste 110, Chantilly, VA 20152-4113 | 2017-12-05 |
| 1245745967 | Angela S Goodson-acevedo | Nurse Practitioner | 14121 Parke Long Ct, Chantilly, VA 20151-1647 | 2017-12-04 |
| 1164936357 | Joanne Aurelien | Nurse Practitioner | 14121 Parke Long Ct, Chantilly, VA 20151-1647 | 2017-11-27 |
| Find all providers in CHANTILLY | ||||
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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.