BYUNG GEUN KIM (NPI# 1114326758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114326758 |
| Entity Type | Individual |
| Full Name | BYUNG GEUN KIM |
| Credential | APN |
| Practice Address |
2501 W Silver Spring Dr Glendale WI 53209-4217 |
| Practice Telephone | 4144619250 |
| Mailing Telephone | 4144619250 |
| Enumeration Date | 2014-08-20 |
| Last Update Date | 2016-02-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 163507 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | LICENSE | 163507 | 01 |
| Street Address |
2501 W SILVER SPRING DR |
| City | GLENDALE |
| State | WI |
| Zip Code | 53209-4217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275170045 | Brittany L Schlicht | Nurse Practitioner | 2501 W Silver Spring Dr, Glendale, WI 53209-4217 | 2019-11-29 |
| 1598180002 | Mobile Physician Clinics, LLC | Health Maintenance Organization | 2501 W Silver Spring Dr, Glendale, WI 53209-4217 | 2014-02-20 |
| 1588955041 | Mahita L Gone | Registered Nurse | 2501 W Silver Spring Dr, Glendale, WI 53209-4217 | 2011-05-02 |
| 1164663381 | Linda Rebekah Rogow | Family Medicine | 2501 W Silver Spring Dr, Glendale, WI 53209-4217 | 2009-03-18 |
| 1609063841 | Medpoint Physical Therapy | Internal Medicine | 2501 W Silver Spring Dr, Glendale, WI 53209-4217 | 2007-10-02 |
| 1255538195 | Digitrace Care Services, Inc | Clinic/Center | 2501 W Silver Spring Dr, Suite 5, Glendale, WI 53209-4217 | 2007-07-02 |
| 1821217860 | Medpoint Urgent Care, LLC | Clinic/Center | 2501 W Silver Spring Dr, Glendale, WI 53209-4217 | 2007-04-25 |
| 1902955933 | Renata B Ptak | Physician Assistant | 2501 W Silver Spring Dr, Glendale, WI 53209-4217 | 2007-01-09 |
| 1972672533 | Medpoint Family Care Center | Internal Medicine | 2501 W Silver Spring Dr, Glendale, WI 53209-4217 | 2006-11-07 |
| 1699844209 | Michael J Ehrmann | Chiropractor | 2501 W Silver Spring Dr, Glendale, WI 53209-4217 | 2006-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780238253 | Niajcia Brookshire | Counselor | 3900 W Brown Deer Rd Suite 200, Brown Deer, WI 53209 | 2019-08-01 |
| 1740751015 | Mary Fuller | Home Health Aide | 3043 N 29th St., Milwaukee, WI 53209 | 2018-12-16 |
| 1154869410 | Jacksonscott2 | Skilled Nursing Facility | 4573 N. 22nd Street, Milwaukee, WI 53209 | 2017-02-07 |
| 1669910469 | Dimera House | In Home Supportive Care | 4002 W Fairount Ave, Milwaukee, WI 53209 | 2017-02-01 |
| 1891248340 | Amy L May | Nurse Practitioner | 3303 W Good Hope Rd, Milwaukee, WI 53209 | 2016-08-02 |
| 1871980193 | Alan R Rosenthal | Pharmacist | 6930 N Beech Tree Dr, Milwaukee, WI 53209 | 2015-04-24 |
| 1104212380 | Reema Shah | Student in an Organized Health Care Education/Training Program | 2400 W. Villard Ave, Milwaukee, WI 53209 | 2015-04-14 |
| 1336534403 | Robert Michael Kitsis | Family Medicine | 9252 N Green Bay Rd Fl 2, Brown Deer, WI 53209 | 2015-04-05 |
| 1962891994 | Kls Community Outreach Teen Center Consulting and Management L.L.C. | Public Health or Welfare | 8330 North Teutonia Ave Suite 103, Brown Deer, WI 53209 | 2015-01-14 |
| 1548659634 | Kls Community Outreach Teen Center Consulting and Management L.L.C. | Early Intervention Provider Agency | 8330 North Teutonia Avenue Suite 103, Brown Deer, WI 53209 | 2015-01-13 |
| Find all providers in zip 53209 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
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| 1992341234 | Kiran Latif | Nurse Practitioner | 1133 Justin Ave Apt 210, Glendale, CA 91201-1825 | 2019-11-21 |
| 1225597727 | Sara Dyane Diaz- Ingram | Nurse Practitioner | 6702 W Bethany Home Rd Ste 14, Glendale, AZ 85303-4402 | 2019-03-14 |
| 1184198442 | Vitality Medical Center Inc | Nurse Practitioner | 1648 W Glenoaks Blvd # 101, Glendale, CA 91201-1827 | 2019-01-18 |
| 1952870628 | Svetlana Serebryanaya | Nurse Practitioner | 6007 W Potter Dr, Glendale, AZ 85308-6731 | 2018-11-24 |
| 1548765225 | Noralie Pizarro Raudszus | Nurse Practitioner | 1505 Wilson Ter Ste 155, Glendale, CA 91206-4032 | 2018-03-26 |
| 1255836904 | Shakeh Haghnazarian | Nurse Practitioner | 1163 Winchester Ave Apt 6, Glendale, CA 91201-1828 | 2018-03-26 |
| 1093261448 | Marina Podlubnaya | Nurse Practitioner | 230 N Maryland Ave Ste 209, Glendale, CA 91206-4282 | 2016-08-26 |
| 1760819866 | Desiree Maducdoc | Nurse Practitioner | 1137 N Central Ave Apt 1524, Glendale, CA 91202-3683 | 2013-10-03 |
| 1578874350 | Silver Continence Care Ca, Nursing PC | Nurse Practitioner | 1010 N Central Ave, Glendale, CA 91202-2937 | 2010-06-28 |
| Find all providers in GLENDALE | ||||
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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.