JEONG KIM (NPI# 1750768107) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750768107 |
| Entity Type | Individual |
| Full Name | JEONG KIM |
| Credential | NP |
| Practice Address |
1301 Pennsylvania Ave Fort Worth TX 76104-2122 |
| Practice Telephone | 8172504906 |
| Practice Fax Number | 8172501815 |
| Mailing Telephone | 8172504906 |
| Mailing Fax Number | 8172501815 |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2019-04-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
AP127743 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
AP127743 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
AP127743 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821634270 | Jeong Moon Kim | Technician/Technologist | 4200 Chino Hills Pkwy Ste 810, Chino Hills, CA 91709-3785 | 2019-11-20 |
| 1578778825 | Jeong Doo Kim | Dentist | 4000 Tyler St Ste A, Riverside, CA 92503-3458 | 2007-05-11 |
| 1861591786 | Jeong H. Kim | Internal Medicine | 11812 N Creek Pkwy N Ste 202, Bothell, WA 98011 | 2006-09-21 |
| 1619986437 | Jeong H Kim | Internal Medicine | 1401 S Beretania St Ste 320, Honolulu, HI 96814-1872 | 2006-08-08 |
| 1184652026 | Jeong J Kim | Nurse Practitioner | 9332 Bridgeport Way Sw, Lakewood, WA 98499-1569 | 2006-06-29 |
| 1053930537 | Jeong Min Kim | Student in an Organized Health Care Education/Training Program | 10833 Le Conte Ave, Los Angeles, CA 90095-3075 | 2020-04-14 |
| 1124369285 | Jeong I Kim | Pharmacist | 1890 Metro Center Dr, Reston, VA 20190-5286 | 2013-03-13 |
| 1326270224 | Jeong Ai Kim | Psychiatry & Neurology | 9310 Sierra Ave, Fontana, CA 92335-5711 | 2009-08-12 |
| 1144439720 | Jeong E. Kim | Dentist | 450 S Glendora Ave, Ste. 106, West Covina, CA 91790-3066 | 2007-05-21 |
| 1447383401 | Jeong Un Kim | Acupuncturist | 545 S Alvarado St, #b, Los Angeles, CA 90057-2903 | 2007-03-13 |
| Street Address |
1301 PENNSYLVANIA AVE |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-2122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144227257 | Robert Louis Quillin | Pediatrics | 1301 Pennsylvania Ave, Fort Worth, TX 76104-2122 | 2005-07-05 |
| 1003414996 | Jana Mitchell | Registered Nurse | 1301 Pennsylvania Ave, Fort Worth, TX 76104-2122 | 2020-10-13 |
| 1730799941 | Brin Alexandra Morris | Registered Nurse | 1301 Pennsylvania Ave, Fort Worth, TX 76104-2122 | 2020-08-03 |
| 1871103168 | Niki Sheth | Registered Nurse | 1301 Pennsylvania Ave, Fort Worth, TX 76104-2122 | 2020-08-03 |
| 1033736863 | Molly Taylor | Respiratory Therapist, Registered | 1301 Pennsylvania Ave, Fort Worth, TX 76104-2122 | 2020-06-27 |
| 1215554175 | Suja Varghese | Nurse Practitioner | 1301 Pennsylvania Ave, Fort Worth, TX 76104-2122 | 2020-06-26 |
| 1538786470 | Amanda A Viehmann | Registered Nurse | 1301 Pennsylvania Ave, Fort Worth, TX 76104-2122 | 2020-06-26 |
| 1376169599 | Heather Nicole Le | Nurse Practitioner | 1301 Pennsylvania Ave, Fort Worth, TX 76104-2122 | 2020-06-23 |
| 1750904249 | Kelli Renee Vogler | Physician Assistant | 1301 Pennsylvania Ave, Fort Worth, TX 76104-2122 | 2020-05-19 |
| 1598387169 | Alim Virji | Radiology | 1301 Pennsylvania Ave, Fort Worth, TX 76104-2122 | 2020-05-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891310009 | Mercy Ngeusang | Nurse Practitioner | 5440 Tuxbury Pond Dr, Fort Worth, TX 76179-1489 | 2020-06-12 |
| 1003475682 | Rachel A Oyejide | Nurse Practitioner | 4205 Golden Horn Ln, Fort Worth, TX 76123-2569 | 2019-06-07 |
| 1457829962 | Nelius Njuguna | Nurse Practitioner | 5204 Bryant Irvin Rd Apt 2119, Fort Worth, TX 76132-3847 | 2018-11-02 |
| 1215442819 | Samuel Nganga Kamau | Nurse Practitioner | 10008 Channing Rd, Fort Worth, TX 76244-8500 | 2017-12-06 |
| 1841739018 | Shannon Boodhwani | Nurse Practitioner | 6100 Harris Pkwy Ste 345, Fort Worth, TX 76132-4134 | 2017-02-21 |
| 1831632306 | Brianna Hawkins | Nurse Practitioner | 10628 Donnis Dr, Fort Worth, TX 76244-6658 | 2016-11-30 |
| 1518359645 | Barbara Evans | Nurse Practitioner | 1001 12th Ave Ste 130, Fort Worth, TX 76104-3926 | 2015-02-26 |
| 1942575329 | Mari J. Finley | Nurse Practitioner | 4503 Anglin Cir, Fort Worth, TX 76140-4205 | 2012-03-18 |
| 1306110366 | Janice Renea Richardson | Nurse Practitioner | 1350 E Lancaster Ave Ste 100, Fort Worth, TX 76102-6671 | 2012-03-07 |
| 1477154490 | Cassandra Jade Hinojosa | Nurse Practitioner | 6301 Harris Pkwy Ste 300, Fort Worth, TX 76132-4266 | 2020-11-05 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
Please comment or provide details below to improve the information on JEONG KIM.
| 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.