Active NPI
Grace Za Kim, MD
- Ophthalmology Physician
- Columbus, OH
National Provider Identifier
1003870643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 35038852K
- Practice address
- 245 Taylor Station Rd
Columbus, OH 43213-4400 - Phone
- (614) 861-0448
- Fax
- (614) 861-7717
- NPI assigned
- Apr 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 35038852K | OH | Primary |
Addresses
Primary practice location
245 Taylor Station Rd
Columbus, OH 43213-4400
Mailing address
245 Taylor Station Rd
Columbus, OH 43213-4400
Phone (614) 861-0448
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0333099 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120530000615 | OH | Practitioner - Ophthalmology | 0345403341 | Practice locations: Columbus, OH |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35038852K | OH | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323734400000",
"number": "1003870643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 TAYLOR STATION RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432134400",
"telephone_number": "614-861-0448",
"fax_number": "614-861-7717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "245 TAYLOR STATION RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432134400",
"telephone_number": "614-861-0448",
"fax_number": "614-861-7717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "GRACE",
"middle_name": "ZA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-12",
"last_updated": "2011-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "OH",
"license": "35038852K",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0333099",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.