CHANG INN KIM (NPI# 1508327818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508327818 |
| Entity Type | Individual |
| Full Name | CHANG INN KIM |
| Credential | PHARMD |
| Practice Address |
57950 Leavenworth St Ste 4e1 Mcconnell Afb KS 67221-3506 |
| Practice Telephone | 3167595277 |
| Practice Fax Number | 3167596776 |
| Mailing Telephone | 3167595277 |
| Mailing Fax Number | 3167596776 |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2019-03-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
1-106889 | KS | Pharmacy Service Providers |
| Street Address |
57950 LEAVENWORTH ST STE 4E1 |
| City | MCCONNELL AFB |
| State | KS |
| Zip Code | 67221-3506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659581197 | Jeffrey Scott Hayes | Licensed Practical Nurse | 57950 Leavenworth St Ste 4e1, Mcconnell Afb, KS 67221-3506 | 2007-05-23 |
| 1952716847 | 22nd Medical Group | Pharmacy | 57950 Leavenworth St Ste 4e1, Mcconnell Afb, KS 67221-3506 | 2014-06-30 |
| 1407296940 | Daniel Richard Galle | Optometrist | 57950 Leavenworth St Ste 4e1, Mcconnell Afb, KS 67221-3505 | 2013-06-28 |
| 1962707067 | Melissa M Wendt | Physician Assistant | 57950 Leavenworth St Ste 4e1, Mcconnell Afb, KS 67221 | 2011-01-20 |
| 1073760542 | Matthew Scott Davis | Physician Assistant | 57950 Leavenworth St Ste 4e1, Mcconnell Afb, KS 67221-3506 | 2008-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922528421 | Rose Lee Samples | Nurse Practitioner | 51950 Leavenworth St., Family Health Clinic 22 Mdg, Mcconnell Afb, KS 67221 | 2017-06-26 |
| 1114247913 | Dawn Marie Clifton | Nurse Practitioner | 57950 Leavenworth Ave Bldg 250, 22d Medical Group, Mcconnell Afb, KS 67221 | 2010-06-03 |
| 1467514489 | 22nd Medical Group | Pharmacy | 57590 Leavenworth Bldg 250, Mcconnell Afb, KS 67221 | 2006-12-15 |
| 1336182153 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | Derby Street, Building 352, Mcconnell Afb, KS 67221 | 2006-06-13 |
| 1578919049 | Kathryn Rachel Kocher | Pediatrics | 57950 Leavenworth St, Mcconnell Afb, KS 67221 | 2016-05-13 |
| 1922232271 | Richard Jimenez Rubi | Military Health Care Provider | 22 Mdg, Mcconnell Afb, KS 67221 | 2009-05-14 |
| 1871581306 | Joshua A Hartman | Emergency Medicine | 57950 Leavenworth St Bldg 248, Mcconnell Afb, KS 67221-3505 | 2005-10-10 |
| 1184242604 | Lindsey Allison Cunningham | Dentist | 57950 Leavenworth St, Wichita, KS 67221-3505 | 2020-07-10 |
| 1164052700 | Taylor Holloway | Family Medicine | 57950 Leavenworth St Bldg 250, Mcconnell Afb, KS 67221-3505 | 2020-01-23 |
| 1669969424 | Alesha Avis Heinz | Student in an Organized Health Care Education/Training Program | 57950 Leavenworth Street, Suite 4e1, Mcconnell Afb, KS 67221-3506 | 2018-04-17 |
| Find all providers in zip 67221 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639719016 | Stacie Lynn Niehues | Pharmacist | 2010 Se 29th St Ste B, Topeka, KS 66605-3311 | 2020-01-13 |
| 1144860164 | Jacqueline Baker | Pharmacist | 8709 W 80th St, Overland Park, KS 66204-3305 | 2020-01-07 |
| 1366815714 | Brandon Thomas | Pharmacist | 4104 S 4th St, Leavenworth, KS 66048-5082 | 2015-11-06 |
| 1861818429 | Katherine Marie Lurk | Pharmacist | 7101 College Blvd Ste 600, Overland Park, KS 66210-2083 | 2014-03-06 |
| 1073865374 | David R Schoech | Pharmacist | 922 W Country Rd, Columbus, KS 66725-3003 | 2012-10-10 |
| 1629343819 | Gary Gene Coleman | Pharmacist | 20816 W 99th St, Lenexa, KS 66220-2699 | 2012-03-20 |
| 1194097766 | Todd Schroeder | Pharmacist | 929 N Saint Francis Street, Via Christi, Wichita, KS 67214 | 2012-01-30 |
| 1952683013 | James Mckee Bredahl | Pharmacist | 17730 189th St, Tonganoxie, KS 66086-5173 | 2011-09-15 |
| 1245510882 | Kevin D. Myers | Pharmacist | 2110 Nw Topeka Blvd, Topeka, KS 66608-1831 | 2011-08-26 |
| 1972800662 | Alireza Ahmadian | Pharmacist | 14631 S Garnett St, Olathe, KS 66062-8411 | 2011-02-16 |
| Find all providers with the same taxonomy | ||||
| City | MCCONNELL AFB |
| Zip Code | 67221 |
Please comment or provide details below to improve the information on CHANG INN 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.