John Junil Kim, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

016006086 Issued in IL

Practice address

1111 Trinity LN Ste 111
Bloomington, IL 61704-8112

Phone

(309) 663-6461

NPI assigned

Apr 8, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carle West Physician Group IncGroup PAC ID 8921420308, 282 clinicians

Advanced Physical Therapy Services, LTD.Group PAC ID 9133101462, shared by 5 NPIs, 216 clinicians

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carle Bromenn Medical Center Hospital, Normal, IL, CCN 140127
• Carle Eureka Hospital Hospital, Eureka, IL, CCN 141309
• St Joseph Medical Center Hospital, Bloomington, IL, CCN 140162
• Saint James Hospital Hospital, Pontiac, IL, CCN 140161

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkim130661@direct.luhs.org
• Direct secure messaging: jkimdpm421929@carlehiedirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Carle Health Care Incorporated

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment Care Compare group NPD
• Carle West Physician Group Inc

  • Family Medicine Physician
  • Normal, IL
  • NPI 1467074138
  Medicare reassignment Care Compare group NPD
• Carle Eureka Hospital

  • Critical Access Hospital
  • Eureka, IL
  • NPI 1184644023
  Medicare reassignment NPD
• Washington Orthopaedic Center, Inc., PS

  • Orthopaedic Surgery Physician
  • Centralia, WA
  • NPI 1689787103
  Medicare reassignment NPD
• Loyola University Medical Center

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  NPD
• Washington Orthopaedic Center, Inc, PS

  • Ambulatory Surgical Clinic/Center
  • Centralia, WA
  • NPI 1134218167
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carle Bromenn Medical Center

  • General Acute Care Hospital
  • Normal, IL
  • NPI 1962424036
  Care Compare affiliation
• Carle Eureka Hospital

  • Critical Access Hospital
  • Eureka, IL
  • NPI 1184644023
  Care Compare affiliation
• Saint James Hospital

  • General Acute Care Hospital
  • Pontiac, IL
  • NPI 1407808090
  Care Compare affiliation
• St Joseph Medical Center

  • General Acute Care Hospital
  • Bloomington, IL
  • NPI 1619916806
  Care Compare affiliation

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

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1023647229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 TRINITY LN STE 111",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617048112",
            "telephone_number": "309-663-6461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2160 S 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "601533328",
            "country_code": "US",
            "telephone_number": "708-216-6906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOHN",
        "middle_name": "JUNIL",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-08",
        "last_updated": "2025-06-06",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016006086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David L Kieser, APN, FNP
• Erika Kietzman, LAT, ATC
• Kim Baldwin Psychological Services, PLLC
• Daniel U Kim, MD
• Danielle F Kim, D.O.
• Alexandra Kindred, PA-C
• Stephen L Kindred, M.D.
• Brittany King, APN
• Joseph B Kingdon, ATC/L
• Amber Kingery

• Foot & Ankle Surgery Podiatrist in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.