SUSAN A KIM (NPI# 1568710523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568710523 |
| Entity Type | Individual |
| Full Name | SUSAN A KIM |
| Credential | NP |
| Practice Address |
275 Varnum Ave Ste 201 Riverside Medical Group Lowell MA 01854 |
| Practice Telephone | 9784529700 |
| Practice Fax Number | 9784416075 |
| Mailing Telephone | 9784529700 |
| Mailing Fax Number | 9784416075 |
| Enumeration Date | 2012-08-24 |
| Last Update Date | 2016-10-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | RN2260046 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339861 | Susan Haesook Kim | Pharmacist | 1400 2nd St, Edmod, Edmond, OK 73034 | 2020-09-01 |
| 1184263634 | Susan Kim | Pharmacist | 14529 28th Dr Se, Mill Creek, WA 98012-5707 | 2020-01-02 |
| 1548780901 | Susan Kim | Marriage & Family Therapist | 12625 High Bluff Dr Ste 103, San Diego, CA 92130-2053 | 2017-06-26 |
| 1013371210 | Susan Kim | Pharmacist | 192 Orchard Park Dr, Apt 287, Davis, CA 95616-5343 | 2016-04-13 |
| 1861893000 | Susan Kim | Dietitian, Registered | 21011 Storrs Rd, Sackets Harbor, NY 13685-3172 | 2014-09-08 |
| 1033559505 | Susan Kim | Counselor | 2900 Eastlake Ave E, Suite 220, Seattle, WA 98102-3012 | 2013-06-28 |
| 1538424080 | Susan Soojin Kim | Specialist | 12 Sterling Pl, 1st Fl, Edgewater, NJ 07020-1415 | 2012-07-11 |
| 1427202456 | Susan Youn Kim | Optometrist | 3184 Queens East St, Eugene, OR 97401-8525 | 2008-11-04 |
| 1184807257 | Susan J. Kim | Physical Medicine & Rehabilitation | 7703 Floyd Curl Dr, Mc7798, San Antonio, TX 78229-3901 | 2007-12-12 |
| 1619019429 | Susan Kim | Acupuncturist | 4950 Wilshire Blvd, Los Angeles, CA 90010-3805 | 2007-02-12 |
| Street Address |
275 VARNUM AVE STE 201 RIVERSIDE MEDICAL GROUP |
| City | LOWELL |
| State | MA |
| Zip Code | 01854 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811905961 | Ajay Nanavati | Internal Medicine | 275 Varnum Ave Ste 201, Riverside Medical Group, Lowell, MA 01854 | 2006-08-04 |
| 1285270579 | Katie Favreau | Nurse Practitioner | 275 Varnum Ave Ste 201, Lowell, MA 01854-2141 | 2019-11-21 |
| 1407313026 | Meghan Keegan | Nurse Practitioner | 275 Varnum Ave Ste 201, Lowell, MA 01854-2141 | 2019-03-01 |
| 1346418472 | Cristina Gabriela Stoica | Internal Medicine | 275 Varnum Ave Ste 201, Riverside Medical Group, Lowell, MA 01854 | 2008-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780224246 | Alexander C Mellin | Specialist/Technologist | Costello Athletic Center, 275 Riverside Street, Lowell, MA 01854 | 2020-01-13 |
| 1831656131 | Shaquilla U Terry | Behavior Technician | 810 Broadway St, Apt 5, Lowell, MA 01854 | 2019-02-23 |
| 1073010187 | John R Dunn | Counselor | Lowell House Inc, 555 Merrimack Street, Lowell, MA 01854 | 2018-04-06 |
| 1730604661 | Grecia Aybar | Counselor | 11 White Street, Lowell, MA 01854 | 2017-08-11 |
| 1659812550 | Krystal Demmons | Counselor | 371 Varnum Ave, Lowell, MA 01854 | 2017-03-13 |
| 1891115366 | Stacey Bourbeau | Counselor | 391 Varnum Avenue Lower Level, Lowell, MA 01854 | 2014-04-23 |
| 1013270446 | Alexandra Miniati | Internal Medicine | 275 Varnum Ave Riverside Medical Group, Ste 201, Lowell, MA 01854 | 2012-06-20 |
| 1750608923 | Elisha S Bartlett | Social Worker | 391 Varnum Avenue, Lowell, MA 01854 | 2010-04-28 |
| 1871820399 | Sandy Ann Thongkhamsouk | Counselor | 391 Varnum St., Lowell, MA 01854 | 2009-11-04 |
| 1427299007 | Kristin A. Larson | Nurse Practitioner | 220 Pawtucket St Suite 300, University Crossing, Lowell, MA 01854 | 2009-03-12 |
| Find all providers in zip 01854 | ||||
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780238659 | Adeyemi Christanah Adeniyi | Nurse Practitioner | 113 Wilder St Ste 200, Lowell, MA 01854-3057 | 2019-07-30 |
| 1477606697 | Patients First Emergency Medicine Consultants PC | Nurse Practitioner | 15061 W 197th Ave, Lowell, IN 46356-9456 | 2007-01-19 |
| 1275509747 | Jill Mary Geoffroy | Nurse Practitioner | 491 Dutton St. - Loft 504, Lowell, MA 01854-0002 | 2006-02-24 |
| 1396739934 | Lisa Ann Brown | Nurse Practitioner | 35 Market St, Lowell, MA 01852-6245 | 2005-09-09 |
| 1285270579 | Katie Favreau | Nurse Practitioner | 275 Varnum Ave Ste 201, Lowell, MA 01854-2141 | 2019-11-21 |
| 1780236786 | Andrea Jennifer Desmond | Nurse Practitioner | 295 Varnum Ave, Lowell, MA 01854-2134 | 2019-07-10 |
| 1154899557 | New England Neurological Associates-lowell, LLC | Nurse Practitioner | 10 George St Ste 300, Lowell, MA 01852-2293 | 2018-11-05 |
| 1013419217 | Julie Frances Vergados Simoneau | Nurse Practitioner | 295 Varnum Ave, Lowell, MA 01854-2134 | 2018-03-02 |
| 1578062535 | Latasha Pittman | Nurse Practitioner | 2072b E Commercial Ave, Lowell, IN 46356-2116 | 2018-02-06 |
| 1366819435 | Tamra Lee Brennan | Nurse Practitioner | 2 Hospital Dr, Pain Management Center, Lowell, MA 01852-1311 | 2015-08-25 |
| Find all providers in LOWELL | ||||
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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.