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JUSTIN KIM
NPI 1780529107
Student in an Organized Health Care Education/Training Program in Mount Vernon, IL

Active since April 22, 2026
1 GOOD SAMARITAN WAY, MOUNT VERNON, IL 62864(618) 899-4600 Get Directions Write a Review

NPPES record last updated: April 22, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Justin Kim NPPES

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

JUSTIN KIM (NPI 1780529107) is an individual student in an organized health care education/training program in Mount Vernon, Illinois and active in the NPI registry since April 2026.

NPPES Registry Identity

NPI1780529107
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJUSTIN KIM
Location Address1 GOOD SAMARITAN WAYMount Vernon, IL 62864-2402
Mailing Address9726 Whistling Valley RdLake Elmo, MN 55042-4455
Phone(618) 899-4600
Sole ProprietorYes
Enumeration DateApril 22, 2026
NPPES CertifiedApril 22, 2026
✔ NPI 1780529107 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
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.
1 GOOD SAMARITAN WAY, Mount Vernon, IL 62864
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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.

DR. EMMANUEL LOUTRIANAKIS MD
Internal Medicine (Interventional Cardiology)
1 GOOD SAMARITAN WAY
MOUNT VERNON, IL 62864
Jefferson County (847) 736-0506
DR. QING KEVIN LUO M.D.
Internal Medicine
1 GOOD SAMARITAN WAY
MOUNT VERNON, IL 62864
Jefferson County (618) 242-4600
GOOD SAMARITAN REGIONAL HEALTH CENTER
Rehabilitation Unit
1 GOOD SAMARITAN WAY
MOUNT VERNON, IL 62864
Jefferson County (618) 242-4600
ADELAIDE HORCHER M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
1 GOOD SAMARITAN WAY
MOUNT VERNON, IL 62864
Jefferson County (618) 242-4600
MRS. JILL CLARKE PHARM. D.
Pharmacist
1 GOOD SAMARITAN WAY
MOUNT VERNON, IL 62864
Jefferson County (618) 899-3426
KENT S QUINN MD
Radiology (Body Imaging)
1 GOOD SAMARITAN WAY, ATTN RADIOLOGY DEPT
MOUNT VERNON, IL 62864
Jefferson County (618) 242-4600
GOOD SAMARITAN REGIONAL HEALTH CENTER
Specialist
1 GOOD SAMARITAN WAY
MOUNT VERNON, IL 62864
Jefferson County (618) 899-4600
DEREK BURNS PHARMD
Pharmacist
1 GOOD SAMARITAN WAY
MOUNT VERNON, IL 62864
Jefferson County (618) 899-3426

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 Justin Kim's NPI number?

The NPI number for Justin Kim is 1780529107. It was assigned to this individual provider in the NPPES registry on April 22, 2026.

Where is Justin Kim located?

Justin Kim practices at 1 Good Samaritan Way, Mount Vernon, IL 62864. The listed phone number is (618) 899-4600.

What is Justin 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 Justin Kim was last updated on April 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.