JAE HYUN SHIM (NPI# 1174142731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174142731 |
| Entity Type | Individual |
| Full Name | JAE HYUN SHIM |
| Credential | MD |
| Practice Address |
300 Singleton Ridge Rd Conway SC 29526-9142 |
| Practice Telephone | 8433478134 |
| Mailing Telephone | 8433478134 |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-04-14 |
| 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 |
| Street Address |
300 SINGLETON RIDGE RD |
| City | CONWAY |
| State | SC |
| Zip Code | 29526-9142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467450643 | Kathleen M Chance | Nurse Anesthetist, Certified Registered | 300 Singleton Ridge Rd, Conway, SC 29526-9142 | 2005-07-12 |
| 1588275101 | Christina Lauren St Clair | Registered Nurse | 300 Singleton Ridge Rd, Conway, SC 29526-9142 | 2020-08-17 |
| 1184248569 | Evan Samuel Culp | Nurse Anesthetist, Certified Registered | 300 Singleton Ridge Rd, Conway, SC 29526-9142 | 2020-06-02 |
| 1023637352 | Tawsif Nadir | Student in an Organized Health Care Education/Training Program | 300 Singleton Ridge Rd, Conway, SC 29526-9142 | 2020-04-16 |
| 1427677053 | Bennett Leanna Haskin | Family Medicine | 300 Singleton Ridge Rd, Conway, SC 29526-9142 | 2020-04-14 |
| 1891314449 | Eric Yunkwen Choi | Student in an Organized Health Care Education/Training Program | 300 Singleton Ridge Rd, Conway, SC 29526-9142 | 2020-04-14 |
| 1487273017 | Tooba Anum | Student in an Organized Health Care Education/Training Program | 300 Singleton Ridge Rd, Conway, SC 29526-9142 | 2020-04-14 |
| 1083242960 | Noman Ghiasi | Family Medicine | 300 Singleton Ridge Rd, Conway, SC 29526-9142 | 2020-03-27 |
| 1336775154 | Kaila Marnan Robbins | Registered Nurse | 300 Singleton Ridge Rd, Conway, SC 29526-9142 | 2020-03-13 |
| 1104451483 | Tracey Michelle Lewis | Registered Nurse | 300 Singleton Ridge Rd, Conway, SC 29526-9142 | 2020-03-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457975237 | Terri L Champion | Massage Therapist | 172 Waccamaw Medical Park Court, Conway, SC 29526 | 2020-06-08 |
| 1689204398 | Alayna Defalco | Clinical Exercise Physiologist | 1320 501 Business, Unit E, Conway, SC 29526 | 2020-01-22 |
| 1124672662 | Proxsys Rx - Sc, LLC | Pharmacy | 300 Singelton Ridge Road, Conway, SC 29526 | 2019-08-01 |
| 1598227431 | Surgery Center of Conway Inc | Clinic/Center | 1405 Main Street, Conway, SC 29526 | 2019-04-01 |
| 1801374962 | Trevor James Hess | Specialist/Technologist | 905 One Landon Loop, Conway, SC 29526 | 2018-08-01 |
| 1851800817 | Katherine Ann Nimphius | Behavioral Analyst | 105 Timberline Dr, Conway, SC 29526 | 2017-09-21 |
| 1922544253 | William Houck | Specialist/Technologist | 925 One Landon Loop, Conway, SC 29526 | 2017-01-10 |
| 1952857278 | Courtney Jeanette Smith | Counselor | 164 Waccamaw Medical Park Dr., Conway, SC 29526 | 2016-08-28 |
| 1336502632 | Jebediah S. Christy, D.d.s - Conway, Pllc | Dentist | 2756 Church St, Conway, SC 29526 | 2016-04-04 |
| 1447615208 | Abl Enterprises, LLC | Optometrist | 113 Citadel Drive, Conway, SC 29526 | 2015-12-22 |
| Find all providers in zip 29526 | ||||
| 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 |
|---|---|---|---|---|
| 1679122998 | Baylee Nicole Kimbrell | Student in an Organized Health Care Education/Training Program | 1018 Clifton St Apt 7, Conway, AR 72034-3988 | 2019-09-09 |
| 1194284364 | Tiffany Elise Eastburn | Student in an Organized Health Care Education/Training Program | 1760 Wysteria Ln, Conway, AR 72034-8444 | 2019-03-18 |
| 1033675814 | Sarah Etta Harrison | Student in an Organized Health Care Education/Training Program | 2912 Celia Dr, Conway, AR 72034-5511 | 2019-02-15 |
| 1235695321 | Elizabeth Catherine Speck | Student in an Organized Health Care Education/Training Program | 3760 Irby Dr, Conway, AR 72034-3381 | 2019-02-14 |
| 1093270746 | Stefan Jordan Mckinney | Student in an Organized Health Care Education/Training Program | 2201 Moix Blvd Apt 411, Conway, AR 72034-6899 | 2019-02-06 |
| 1316435662 | Ashley Nolen | Student in an Organized Health Care Education/Training Program | 835 S Donaghey Ave Apt 411, Conway, AR 72034-7050 | 2018-04-23 |
| 1073014973 | Hannah Ashley Thornton | Student in an Organized Health Care Education/Training Program | 1361b Davis St, Conway, AR 72034-3963 | 2018-02-26 |
| 1699274910 | Ja'brea Janay Joiner | Student in an Organized Health Care Education/Training Program | 1025 S Donaghey Ave Apt 715, Conway, AR 72034-6290 | 2018-02-02 |
| 1790222198 | Jordan Gregory | Student in an Organized Health Care Education/Training Program | 3065 Dave Ward Dr Apt 213, Conway, AR 72034-9411 | 2017-01-23 |
| 1265832661 | Chelcie Ford | Student in an Organized Health Care Education/Training Program | 407 Katie Ln, Conway, AR 72034-7942 | 2014-09-04 |
| Find all providers in CONWAY | ||||
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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.