NPI Code Detail JSON Logo

1811171960 NPI number — JIWON KIM O.M.D

NPI Number: 1811171960
Health Care Provider/Practitioner: JIWON KIM O.M.D

Information about “1811171960” NPI (JIWON KIM O.M.D) exists in 1811171960 in HTML format HTML  |  1811171960 in plain Text format TXT  |  1811171960 in PDF (Portable Document Format) PDF  |  1811171960 in an XML format XML  formats.

NPI Number : 1811171960 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1811171960",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KIM",
    "FirstName": "JIWON",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "O.M.D",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "KIM",
    "OtherFirstName": "JESSE",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "O.M.D",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "5006 TAMIAMI TRL N",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NAPLES",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "34103-2801",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "239-961-0585",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5006 TAMIAMI TRL N",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NAPLES",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "34103-2801",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "239-304-2000",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/26/2007",
    "LastUpdateDate": "08/11/2008",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "171100000X",
        "TaxonomyName": "Acupuncturist",
        "LicenseNumber": "AP2484",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.