ELLEN KIM (NPI# 1275161879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275161879 |
| Entity Type | Individual |
| Full Name | ELLEN KIM |
| Credential | MD |
| Practice Address |
1438 S Grand Blvd Saint Louis MO 63104-1027 |
| Practice Telephone | 3149774850 |
| Practice Fax Number | 3149774876 |
| Mailing Telephone | 3149774850 |
| Mailing Fax Number | 3149774876 |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2020-03-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3635 Vista Ave, Saint Louis, MO 631102500 | 3145778000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548331564 | Ellen Hyun Ju Kim | Pediatrics | 2329 East Huntington Drive, Duarte, CA 91010 | 2006-11-13 |
| 1124024229 | Ellen M Kim | Internal Medicine | 19200 N Kelsey St, Monroe, WA 98272-1431 | 2005-06-23 |
| 1265982821 | Ellen Kim | Occupational Therapist | 8135 Painter Ave Ste 200, Whittier, CA 90602-3168 | 2016-10-07 |
| 1710374103 | Ellen Kim | Radiology | 75 Francis St, Asb1- L2, Boston, MA 02115-6110 | 2015-04-23 |
| 1013321108 | Ellen Kim | Pharmacist | 3300 Centennial Ln, Ellicott City, MD 21042-3600 | 2014-06-17 |
| 1982044806 | Ellen Kim | Pharmacist | 164 W Chelten Ave, Philadelphia, PA 19144-3302 | 2013-06-25 |
| 1912249400 | Ellen Sohyun Kim | Internal Medicine | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2013-03-22 |
| 1689847584 | Ellen Kim | Pharmacist | 1000 1st Ave, New York, NY 10022-4105 | 2008-04-11 |
| 1912069329 | Ellen H Kim | Family Medicine | 2324 Second Street Pike, Wrightstown Family Medicine PC, Wrightstown, PA 18940-4110 | 2006-12-14 |
| 1275600637 | Ellen Kim | Family Medicine | 4253 Montgomery Blvd Ne, Suite 100, Albuquerque, NM 87109-1106 | 2006-11-29 |
| Street Address |
1438 S GRAND BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63104-1027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801869136 | St Louis University | Psychiatry & Neurology | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2006-02-08 |
| 1477181071 | Kevin Chacko Varghese | Student in an Organized Health Care Education/Training Program | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2020-03-30 |
| 1609404201 | Allison Montgomery | Student in an Organized Health Care Education/Training Program | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2020-03-30 |
| 1457989055 | Marissa Alexandra Hirsch | Student in an Organized Health Care Education/Training Program | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2020-03-30 |
| 1366070963 | Rajat Duggirala | Student in an Organized Health Care Education/Training Program | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2020-03-30 |
| 1184252785 | Derek Wayne Brown | Student in an Organized Health Care Education/Training Program | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2020-03-30 |
| 1619505591 | Farid Khasiyev | Student in an Organized Health Care Education/Training Program | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2020-03-27 |
| 1578190393 | Kelsey Roberts | Psychiatry & Neurology | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2020-03-23 |
| 1457912230 | Katherine Mcarthur | Student in an Organized Health Care Education/Training Program | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2019-06-24 |
| 1780248112 | Muhammad Khurram Afzal | Student in an Organized Health Care Education/Training Program | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2019-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407469570 | Family Care Health Centers | Clinic/Center | 2717 Sidney Street, St. Louis, MO 63104 | 2020-08-28 |
| 1023638038 | Laura Ann Humphrey | Physician Assistant | Allied Health Building 3437 Caroline Street, Room 3015, Saint Louis, MO 63104 | 2020-04-20 |
| 1174187264 | Ahsan Ali | Student in an Organized Health Care Education/Training Program | 1438 South Grand Blvd, Monteleone Hall, St. Louis, MO 63104 | 2019-04-24 |
| 1205359916 | Brenda Eve Ladin | Behavior Technician | 1221 Allen Market Lane Rear, St. Louis, MO 63104 | 2017-07-25 |
| 1841722063 | Gustavo G Mendez | Student in an Organized Health Care Education/Training Program | 1465 South Grand Bulevard Rm 2717, Ssm Health Cardinal Glennon Children's Hospital, Saint Louis, MO 63104 | 2017-03-28 |
| 1053776716 | Carmella Harper | Respiratory Therapist, Certified | 2678 Park Ave, St Louis, MO 63104 | 2015-12-23 |
| 1922485986 | Alexander Tremont | Internal Medicine | 1402 S Grand Blvd Rm M260, Saint Louis, MO 63104 | 2015-04-29 |
| 1306233341 | Healthcare R Us | Home Health | 2859 Sidney St, St Louis, MO 63104 | 2015-04-16 |
| 1396159091 | Daniela Hermelin | Pathology | 1402 South Grane, St. Louis, MO 63104 | 2014-06-20 |
| 1992117881 | Kelly Denise Durbin | Social Worker | 1920 S 7th St, Saint Louis, MO 63104 | 2014-05-27 |
| Find all providers in zip 63104 | ||||
| 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 |
|---|---|---|---|---|
| 1245845908 | Ali Hamzehloo | Student in an Organized Health Care Education/Training Program | 1155 Appleseed Ln Unit D, Saint Louis, MO 63132-3239 | 2020-09-10 |
| 1114539137 | Brooke Marissa Tubbs | Student in an Organized Health Care Education/Training Program | 5135 Redstone Rd, Saint Louis, MI 48880-9602 | 2020-08-20 |
| 1508475245 | Irfan Yasin | Student in an Organized Health Care Education/Training Program | 1402 S Grand Blvd Dept Of, Saint Louis, MO 63104-1004 | 2020-07-29 |
| 1457978231 | Katherine Coates | Student in an Organized Health Care Education/Training Program | 4534 Olive St Apt 306, Saint Louis, MO 63108-1869 | 2020-06-29 |
| 1184248437 | Catherine Gaines | Student in an Organized Health Care Education/Training Program | 362 S Maple Ave, Saint Louis, MO 63119-3824 | 2020-06-02 |
| 1922620947 | Nicole Werner | Student in an Organized Health Care Education/Training Program | 9669 Amona Ct, Saint Louis, MO 63123-6535 | 2020-05-13 |
| 1043831787 | Reed Welch | Student in an Organized Health Care Education/Training Program | 1501 Fairmount Ave, Saint Louis, MO 63139-3628 | 2020-05-05 |
| 1437779097 | Victoria Emanuelson | Student in an Organized Health Care Education/Training Program | 4048 Cleveland Ave Apt 3w, Saint Louis, MO 63110-3958 | 2020-04-23 |
| 1831727502 | Kiran Ashok Patel | Student in an Organized Health Care Education/Training Program | 4050 W Pine Blvd Apt 3311b, Saint Louis, MO 63108-3294 | 2020-03-30 |
| 1699301507 | Morgann Madill | Student in an Organized Health Care Education/Training Program | 4144 De Tonty St Apt 1d, Saint Louis, MO 63110-2511 | 2020-03-23 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63104 |
Please comment or provide details below to improve the information on ELLEN 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.