JAE YOON KIM NPI 1013595107

NPI Information

  • NPI: 1013595107
  • Provider Name: JAE YOON KIM
  • Classification: Podiatrist - 213ES0103X
  • Specialization: Foot & Ankle Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 350 W WILSON BRIDGE RD STE 200
    WORTHINGTON, OH
    ZIP 43085
  • Phone: (614) 895-8747

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NPI Details

Jae Yoon Kim is a foot and ankle surgery podiatrist in Worthington, OH with 4 years of experience. Jae Yoon Kim NPI is 1013595107. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: CALIFORNIA SCHOOL OF PODIATRIC MEDICINE
Graduation Year:2021

The provider's business location address is:

350 W WILSON BRIDGE RD STE 200
WORTHINGTON, OH
ZIP 43085-591
Phone: (614) 895-8747
Fax: (614) 895-8810

The NPI 1013595107 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 3/30/2021 and was last updated on 4/10/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213E00000XPodiatrist36.004128OHIONo
2261QP1100XClinic/CenterPodiatricNo
3390200000XStudent in an Organized Health Care Education/Training ProgramNo
4213ES0103XPodiatristFoot & Ankle Surgery36.004128OHIOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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