DR. HEE WON KIM (NPI# 1013024819) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013024819 |
| Entity Type | Individual |
| Full Name | DR. HEE WON KIM |
| Credential | M.D. |
| Practice Address |
1200 N Beaver St Flagstaff AZ 86001-3118 |
| Mailing Address |
1200 N Beaver St Payer Credentialing Flagstaff AZ 86001-3118 |
| Practice Telephone | 9287732120 |
| Practice Fax Number | 9287732189 |
| Mailing Telephone | 9287732559 |
| Mailing Fax Number | 9282136292 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2015-12-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
46988 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 627284 | 05 |
| Street Address |
1200 N BEAVER ST |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001-3118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346241189 | Alvin B Elisco | Internal Medicine | 1200 N Beaver St, Fmc Hospitalists, Flagstaff, AZ 86001-3118 | 2005-08-02 |
| 1285240515 | Amika Noel | Nurse Anesthetist, Certified Registered | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-09-22 |
| 1669084190 | Margaret Grace Mcgough | Registered Nurse | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-08-17 |
| 1942818398 | Regan Rowson | Registered Nurse | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-07-21 |
| 1871118984 | Nancy Gloria Flores | Audiologist | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-06-15 |
| 1679100705 | Kristy Anderson | Occupational Therapist | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-03-26 |
| 1164058087 | Bryan J Ebeling | Nurse Practitioner | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-03-23 |
| 1447808407 | Bryce Aldworth Randall | Registered Nurse | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2019-09-03 |
| 1851952162 | Samuel Small | Nurse Practitioner | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2019-06-26 |
| 1235797283 | Rebecca R Boger | Dietitian, Registered | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2019-06-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
| 1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
| 1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
| Find all providers in zip 86001 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144492299 | Northern Arizona Pediatric Intensive Care Specialists | Pediatrics | 77 W Forest Ave Ste 304, Flagstaff, AZ 86001-1481 | 2008-03-28 |
| 1912948530 | Susan Moore Haefner | Pediatrics | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2006-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306467154 | Pediatrics Healthcare Associates | Pediatrics | 10645 N Tatum Blvd Ste C200-272, Phoenix, AZ 85028-3068 | 2020-05-04 |
| 1225051618 | Obstetrics and Pediatrics Subspecialty Group of Kansas and Missouri Pa | Pediatrics | 4722 N 24th St Ste 150, Phoenix, AZ 85016-4860 | 2006-07-26 |
| 1043237548 | Karen Renee Underwood | Pediatrics | 11834 N 142nd St, Scottsdale, AZ 85259-3791 | 2006-07-17 |
| 1255833158 | Jennifer Hann | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2018-03-06 |
| 1033588959 | Yuki Yasaka | Pediatrics | 1400 S Dobson Rd, Mesa, AZ 85202-4707 | 2015-09-21 |
| 1720408313 | Shefali Aggarwal | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2014-04-22 |
| 1821433467 | Elizabeth Rose Diaz | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2013-05-09 |
| 1700143674 | Renee Devor | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016 | 2012-04-17 |
| 1124305578 | Jeffrey H Hill Md Phc Pllc | Pediatrics | 1800 E Van Buren St, Phoenix, AZ 85006-3742 | 2011-11-14 |
| 1174847255 | David S Nathalang | Pediatrics | 1501 N Campbell Avenue, Tucson, AZ 85724 | 2010-03-18 |
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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.