Jackie Kim, is a
Student In An Organized Health Care Education/training Program based in Beaufort, South Carolina. Jackie Kim is licensed to practice in * (Not Available) (license number ) and current practice location is
16 Wando Pl, Beaufort, South Carolina. can be reached at office (for appointments etc.) via phone at
(201) 600-2206.
NPI number for Jackie Kim is 1376427815 and current mailing address is 16 Wando Pl, Beaufort, South Carolina.
does not participate in medicare program and thus does not accept medicare assignments. NPI Number is 1376427815.
Provider's Profile
| Full Name | Jackie Kim |
|---|
| Gender | |
|---|
| Speciality | Student In An Organized Health Care Education/training Program |
|---|
| Location | 16 Wando Pl, Beaufort, South Carolina |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1376427815
- Provider Enumeration Date: 08/05/2025
- Last Update Date: 08/05/2025
Medical Identifiers
Medical identifiers for Jackie Kim such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1376427815 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jackie Kim is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jackie Kim,
16 Wando Pl,
Beaufort, SC 29906-6041
Ph: (201) 600-2206 | Jackie Kim,
16 Wando Pl,
Beaufort, SC 29906-6041
Ph: (201) 600-2206 |
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