JAI EUN KIM
NPI 1609671486
Nurse Practitioner in West Columbia, SC

Q: What is Jai Kim's NPI number?

The NPI number for Jai Kim is 1609671486. It was assigned to this individual provider in the NPPES registry on February 17, 2025.

Q: What is Jai Kim's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Jai Kim was last updated on October 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.

Active since February 17, 2025PECOS Enrolled

103 SUM MOR DR, WEST COLUMBIA, SC 29169(803) 254-4699 Get Directions Write a Review

NPPES record last updated: October 12, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 12, 2025, Sep 16, 2025, Feb 17, 2025 (3 updates tracked since 2025).

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About Jai Eun Kim NPPES

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

JAI EUN KIM (NPI 1609671486) is an individual nurse practitioner in West Columbia, South Carolina, licensed in South Carolina (30777) and active in the NPI registry since February 2025. She is enrolled in Medicare PECOS and is a graduate of University Of South Carolina School Of Medicine (2025).

NPPES Registry Identity

NPI1609671486

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameJAI EUN KIM

Location Address103 SUM MOR DRWest Columbia, SC 29169-4828

Mailing Address103 Sum Mor DrWest Columbia, SC 29169-4828 · (803) 254-4699

Phone(803) 254-4699

Sole ProprietorNo

Medical School CMSUniversity Of South Carolina School Of MedicineGraduated 2025

Enumeration DateFebruary 17, 2025

Last NPPES UpdateOctober 12, 20253 updates tracked since enumeration

NPPES CertifiedOctober 12, 2025

✔ NPI 1609671486 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in SC · 30777

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

103 SUM MOR DR, West Columbia, SC 29169

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jai Eun Kim is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4183115603

PECOS Enrollment IDI20251112003706

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29169 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.18 typical visit price

range $53.57 – $163.84

Typical copayment $20.79 (range $13.39 – $40.96)

Most-billed visit code 99203

Established Patient

$95.12 typical visit price

range $16.96 – $133.52

Typical copayment $23.78 (range $4.24 – $33.38)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 12

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

DR. TIFFANY NICOLE HOWARD MD

Physical Medicine & Rehabilitation

103 SUM MOR DR, VITALITY MEDICAL CENTERS, INC.
WEST COLUMBIA, SC 29169

Lexington County (803) 218-9886

DR. JOHN EVANS STAVRAKOS MD

Physical Medicine & Rehabilitation