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Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Jack Kim

Pharmacist in Maplewood, MN · enumerated 2023 · practices at Supervalu Pharmacies Inc.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1770264103

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Registry record

Entity type Individual (Type 1)
Name Jack Kim
Sex Male
Practice address 100 County Road B W, Maplewood, MN, 55117
Phone (608) 772-8773
Enumeration date Jul 27, 2023
Last updated in NPPES Aug 28, 2024

Taxonomy & licenses

183500000X Pharmacist Pharmacy Service Providers · License PH-4988 (HI) Secondary
183500000X Pharmacist Pharmacy Service Providers · License 126132 (MN) Primary
183500000X Pharmacist Pharmacy Service Providers · License 22263 (WI) Secondary

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Is NPI 1770264103 active?
Yes, as of the latest NPPES snapshot, NPI 1770264103 is active (record last updated 2024-08-28).
How do I verify Jack Kim's NPI record?
Cross-check NPI 1770264103 against the official CMS registry at npiregistry.cms.hhs.gov. This page mirrors the same public NPPES data with a monthly snapshot.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-08-28.