Active NPI
Peggy Kim, MD, MS, MBA
- Pain Medicine Physician
- Seattle, WA
National Provider Identifier
1023307105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine Physician
- License
- 65901
- Practice address
- 1660 S Columbian Way
Seattle, WA 98108-1532 - Phone
- (206) 277-5177
- NPI assigned
- Mar 29, 2011
- 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 |
|---|---|---|---|---|
| Pain Medicine Physician | 208VP0000X | 65901 | WI | Primary |
Addresses
Primary practice location
1660 S Columbian Way
Seattle, WA 98108-1532
Mailing address
1660 S Columbian Way
Seattle, WA 98108-1532
Phone (206) 277-5177
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Business Administration, Doctor of Medicine, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65901 | WI | MD | Pain Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655769600000",
"number": "1023307105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1660 S COLUMBIAN WAY",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981081532",
"telephone_number": "206-277-5177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1660 S COLUMBIAN WAY",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981081532",
"telephone_number": "206-277-5177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "PEGGY",
"credential": "MD, MS, MBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-29",
"last_updated": "2022-06-21",
"certification_date": "2022-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "208VP0000X",
"taxonomy_group": "",
"desc": "Pain Medicine, Pain Medicine",
"state": "WI",
"license": "65901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.