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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. JAEJOONG KIM MD
NPI 1306582457
Student in an Organized Health Care Education/Training Program in Minneapolis, MN

Active since May 11, 2022
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454(612) 273-9824 Get Directions Write a Review

NPPES record last updated: July 17, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 17, 2026, May 11, 2022 (2 updates tracked since 2022).

About Dr. Jaejoong Kim Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JAEJOONG KIM MD (NPI 1306582457) is an individual student in an organized health care education/training program in Minneapolis, Minnesota, licensed in Minnesota (82742) and active in the NPI registry since May 2022.

NPPES Registry Identity

NPI1306582457
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. JAEJOONG KIMCredential: MD
Location Address2450 RIVERSIDE AVEMinneapolis, MN 55454-1450
Mailing Address2450 Riverside AveMinneapolis, MN 55454-1450 · (612) 273-9824
Phone(612) 273-9824
Sole ProprietorNo
Enumeration DateMay 11, 2022
Last NPPES UpdateJuly 17, 20262 updates tracked since enumeration
NPPES CertifiedJuly 17, 2026
✔ NPI 1306582457 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in MN · 82742
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2450 RIVERSIDE AVE, Minneapolis, MN 55454
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHELLE IRENE GRAY
Rehabilitation Practitioner
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
DR. KATHLEEN F SADAK MD
Pediatrics
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-6402
DR. ADMATHA MUTHYALA WINFRED MD
Internal Medicine (Geriatric Medicine)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
KELLY SCHELLER WILLIAMS
Dietitian, Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-3216
MRS. MARY SUSAN CLIPP CPNP-AC
Nurse Practitioner (Pediatrics, Critical Care)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 365-3100
DANIEL TESFAYE KEBED MD
Internal Medicine
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MS. CHELSEA ANJELICA MIELKE PA-C
Physician Assistant
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MRS. JESSICA LYNN MCADAM
Nurse Anesthetist, Certified Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-8383

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jaejoong Kim's NPI number?

The NPI number for Jaejoong Kim is 1306582457. It was assigned to this individual provider in the NPPES registry on May 11, 2022.

Where is Jaejoong Kim located?

Jaejoong Kim practices at 2450 Riverside Ave, Minneapolis, MN 55454. The listed phone number is (612) 273-9824.

What is Jaejoong Kim's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Jaejoong Kim was last updated on July 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 28 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.