HAYUN KIM (NPI# 1457796179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457796179 |
| Entity Type | Individual |
| Full Name | HAYUN KIM |
| Credential | ANP-C |
| Practice Address |
612 W Baseline Rd Mesa AZ 85210 |
| Mailing Address |
612 W Baseline Rd Mesa AZ 85210-6041 |
| Practice Telephone | 4808349039 |
| Practice Fax Number | 4809647802 |
| Mailing Telephone | 4808349039 |
| Mailing Fax Number | 4809647802 |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2016-12-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN110675 | AZ | Nursing Service Providers |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
AP4723 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
612 W BASELINE RD |
| City | MESA |
| State | AZ |
| Zip Code | 85210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588692479 | Ijaz Ali | Internal Medicine | 612 W Baseline Rd, Mesa, AZ 85210-6041 | 2006-06-29 |
| 1104344969 | Licel Tumpap | Nurse Practitioner | 612 W Baseline Rd, Mesa, AZ 85210-6041 | 2017-08-31 |
| 1336686187 | Valley Kidney Corp | Internal Medicine | 612 W Baseline Rd, Mesa, AZ 85210-6041 | 2017-01-31 |
| 1831402429 | Roopashree Prabhushankar | Internal Medicine | 612 W Baseline Rd, Mesa, AZ 85210-6041 | 2010-07-23 |
| 1285946707 | Sandra Sue Gaiser | Specialist | 612 W Baseline Rd, Mesa, AZ 85210-6041 | 2010-07-13 |
| 1467779413 | Ramya Vejella | Internal Medicine | 612 W Baseline Rd, Mesa, AZ 85210-6041 | 2010-04-30 |
| 1497082432 | Manjunath Shivamanya Kottalgi | Internal Medicine | 612 W Baseline Rd, Mesa, AZ 85210-6041 | 2009-11-12 |
| 1154557866 | Ruchir Sureshbhai Patel | Internal Medicine | 612 W Baseline Rd, Mesa, AZ 85210-6041 | 2009-06-09 |
| 1114175312 | Prashant Kolar | Internal Medicine | 612 W Baseline Rd, Mesa, AZ 85210-6041 | 2008-09-03 |
| 1992981153 | Sridhar G Nair | Internal Medicine | 612 W Baseline Rd, Mesa, AZ 85210-6041 | 2008-01-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497382501 | Mesa Center for Family Medicine | Internal Medicine | 2034 S Alma School Road, Suite #101, Mesa, AZ 85210 | 2020-03-26 |
| 1780177121 | Jessica Cannata | Speech-Language Pathologist | 2150 S Country Club Rd, Suite 20, Mesa, AZ 85210 | 2018-06-11 |
| 1831680305 | Alexandra Katherine Ebong | Nurse Practitioner | 1950 S. Country Club Drive, Ste 102, Mesa, AZ 85210 | 2018-05-21 |
| 1548762719 | Russell D. Meldrum, M.d. Pllc | Orthopaedic Surgery | 855 W. Southern Ave., #1114, Mesa, AZ 85210 | 2018-03-05 |
| 1023510435 | Denise M Bruno-krupp | Counselor | 1830 S. Alma School Rd. Suite 101, Mesa, AZ 85210 | 2018-03-01 |
| 1609374529 | Gene R Lullo | Social Worker | 1830 S Alma School Rd Suite 101, Mesa, AZ 85210 | 2018-01-25 |
| 1295264000 | Ashley P Smith | Naturopath | 601 S Alma School Rd, Apt 101, Mesa, AZ 85210 | 2017-06-06 |
| 1386184059 | Brittany Johnson | Counselor | 1745 S Alma School Rd Ste 230, Mesa, AZ 85210 | 2017-03-01 |
| 1487190880 | Mesa Valley Modern Dentistry, LLP | Dentist | 1712 S, Country Club Drive, Ste 104, Mesa, AZ 85210 | 2017-01-10 |
| 1821544529 | Sandra Coren | Licensed Practical Nurse | 32 S Mcdonald, Tlc, Mesa, AZ 85210 | 2016-09-01 |
| Find all providers in zip 85210 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083089460 | White Glove Health | Nurse Practitioner | 2906 S Lynch Cr, Mesa, AZ 85212 | 2015-12-10 |
| 1023489192 | Janine Hope Altobelli | Nurse Practitioner | 6840 E Brown Rd Ste 101, Mesa, AZ 85207-3759 | 2015-10-14 |
| 1205144946 | Jonna O Anderson | Nurse Practitioner | 1106 N Gilbert Rd Ste 2, Pmb188, Mesa, AZ 85203-5143 | 2010-09-15 |
| 1538476072 | Manuela Vital | Nurse Practitioner | 6859 E. Rembrandt Ave, Suite 117, Mesa, AZ 85212-3630 | 2010-09-03 |
| 1538200530 | Karen Kay Ballard | Nurse Practitioner | 1710 W. Southern Ave, Concentra - Mesa, Mesa, AZ 85034 | 2007-02-11 |
| 1083703045 | Joellen Beard Embry | Nurse Practitioner | 2204 S Dobson Rd Ste 203, Mesa, AZ 85202 | 2006-10-11 |
| 1487637906 | Pamela L Morris | Nurse Practitioner | 7214 E Avesta Cir, Mesa, AZ 85208-1128 | 2005-11-29 |
| 1255336905 | Julie A Stott | Nurse Practitioner | 7254 E Southern Ave, Ste. 105, Mesa, AZ 85209-1817 | 2005-06-18 |
| 1477012045 | Sleepwerx, LLC | Nurse Practitioner | 3514 N Power Rd Ste 127, Mesa, AZ 85215-2911 | 2019-03-13 |
| 1821441718 | Amy Kleinhans | Nurse Practitioner | 6750 E Baywood Ave, Suite 301, Mesa, AZ 85206-1749 | 2016-07-15 |
| Find all providers in MESA | ||||
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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.