KYUNGSUN JEONG KIM (NPI# 1619245529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619245529 |
| Entity Type | Individual |
| Full Name | KYUNGSUN JEONG KIM |
| Credential | PHARM D |
| Practice Address |
5353 S 960 E #103 Salt Lake City UT 84117-3569 |
| Mailing Address |
5353 S 960 E Salt Lake City UT 84117-3569 |
| Practice Telephone | 8012884013 |
| Practice Fax Number | 8012882485 |
| Mailing Telephone | 8012880413 |
| Mailing Fax Number | 8012882485 |
| Enumeration Date | 2011-12-06 |
| Last Update Date | 2011-12-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 58905541701 | UT | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | UTAH DEPARTMENT OF COMMERCE FOR PHARMACY | 58905541701 | 01 |
| Street Address |
5353 S 960 E #103 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84117-3569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346597507 | J. Dayne Petersen M.d., PC | Clinic/Center | 5353 S 960 E, #150, Salt Lake City, UT 84117-3569 | 2012-08-07 |
| 1689957763 | Jessica Blanchard | Pharmacist | 5353 S 960 E, Salt Lake City, UT 84117-3569 | 2011-09-24 |
| 1053693705 | Eric Mckeon | Pharmacist | 5353 S 960 E, Salt Lake City, UT 84117-3569 | 2011-09-19 |
| 1215105804 | Jason Dayne Petersen | Plastic Surgery | 5353 S 960 E, #150, Salt Lake City, UT 84117-3569 | 2008-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063052256 | Abundant Dental Care, P.C. | Dentist | 1548 E 4500 S #104, Holladay, UT 84117 | 2020-01-15 |
| 1578127221 | Signature Utah Dental Partners PC | Clinic/Center | 2240 E Murray Holladay Rd, Holladay, UT 84117 | 2019-04-29 |
| 1700392974 | Marette Monson, LLC | Community/Behavioral Health | 2180 East 4500 South, Suite 105, Holladay City, UT 84117 | 2017-12-23 |
| 1942714639 | Harmon City Inc | Pharmacy | 4675 South Holladay Blvd, Holladay, UT 84117 | 2017-11-17 |
| 1881119444 | Brianna Stewart | Physical Medicine & Rehabilitation | 5151 South 900 East, Suite 100, Salt Lake City, UT 84117 | 2017-08-04 |
| 1861842874 | Whitney Aste | Dentist | 1548 E 4500 S Ste 104, Salt Lake City, UT 84117 | 2016-06-21 |
| 1922403765 | Tri-peak, Pllc | Psychologist | 4535 S 2300 E, Suite B, Salt Lake City, UT 84117 | 2014-10-22 |
| 1356689566 | Mckenzie Vierig | Marriage & Family Therapist | 4568 S Highland Dr Ste 380, Millcreek, UT 84117 | 2013-01-22 |
| 1821348640 | Fabiola Marquez Jamieson | Social Worker | 4500 S 2180 E, Suite 165, Holladay, UT 84117 | 2012-09-19 |
| 1073882882 | Amy Rose White | Social Worker | 4500 South 2180 East, Suite 165, Holladay, UT 84117 | 2011-12-22 |
| Find all providers in zip 84117 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245830108 | Chadwick M Smith | Pharmacist | 7494 S 2135 E, Salt Lake City, UT 84121-4970 | 2020-10-29 |
| 1568074318 | Kelli Thorup | Pharmacist | 458 E Emerson Ave, Salt Lake City, UT 84115-1531 | 2020-08-21 |
| 1376154435 | James Lindsay Clark | Pharmacist | 201 S 1300 E Ste 101, Salt Lake City, UT 84102-2608 | 2020-08-12 |
| 1699392530 | Rebecca Lavasani | Pharmacist | 1813 E Orchard Dr, Salt Lake City, UT 84106-3258 | 2020-06-26 |
| 1912541772 | Alesia Lynne Hanson | Pharmacist | 2233 S Presidents Dr Ste B, Salt Lake City, UT 84120-7244 | 2019-11-04 |
| 1316596554 | Adam Davies | Pharmacist | 1280 E Stringham Ave., Salt Lake City, UT 84106 | 2019-09-10 |
| 1346899085 | Nathan Wilson | Pharmacist | 1950 Circle of Hope Dr Ste N1780, Salt Lake City, UT 84112-5500 | 2019-09-05 |
| 1437711918 | Hillary Hansen Parkin | Pharmacist | 85 N Medical Dr, Salt Lake City, UT 84112-1100 | 2019-07-03 |
| 1972087328 | Reza Salman | Pharmacist | 4720 S Fortuna Way, Salt Lake City, UT 84124-5620 | 2018-09-21 |
| 1801373022 | John Gardner | Pharmacist | 1280 E Stringham Ave, Salt Lake City, UT 84106-2490 | 2018-07-20 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84117 |
Please comment or provide details below to improve the information on KYUNGSUN JEONG 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.