Organization Active NPI

Kim Chiropractic & Rehab Center - Elkins Park Inc

  • Chiropractor
  • Elkins Park, PA
National Provider Identifier
1013108778
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
KIM CHIROPRACTIC & REHAB CENTER - ELKINS PARK INC
Practice address
921 W Cheltenham Ave
Elkins Park, PA 19027-3208
Phone
(215) 782-1235
Fax
(215) 782-1239
NPI assigned
Aug 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jhan D Kim, L.AC., D.C.NPI 1245201888
Title
Doctor
Phone
(267) 342-0178

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X

Addresses

Primary practice location

921 W Cheltenham Ave
Elkins Park, PA 19027-3208

Mailing address

921 W Cheltenham Ave
Elkins Park, PA 19027-3208
Phone (215) 782-1235

Other practice location 1

7301 Mountain Avenue
Elkins Park, PA 19027
Phone (215) 782-1237

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111103000127 PA Part B Supplier - Clinic/Group Practice 2769655919 Receives reassigned benefits from 3 practitioners
Practice locations: Elkins Park, PA

National Provider Directory

National Provider Directory

Locations

1400 Willow Ave
Ste B1
Elkins Park, PA 19027
Phone (215) 635-1160

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687478400000",
    "number": "1013108778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 W CHELTENHAM AVE",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190273208",
            "telephone_number": "215-782-1235",
            "fax_number": "215-782-1239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 W CHELTENHAM AVE",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190273208",
            "telephone_number": "215-782-1235",
            "fax_number": "215-782-1239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7301 Mountain Avenue",
            "address_purpose": "LOCATION",
            "city": "Elkins Park",
            "state": "PA",
            "postal_code": "19027",
            "country_code": "US",
            "telephone_number": "215-782-1237",
            "fax_number": "215-782-1239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KIM CHIROPRACTIC & REHAB CENTER - ELKINS PARK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JHAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "267-342-0178",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "L.AC., D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkins Park, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.