Organization Active NPI

Kim Chiropractic Clinic PA

  • Chiropractor
  • Apopka, FL
National Provider Identifier
1043351653
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
FL CH0007351 Issued in FL
Legal business name
KIM CHIROPRACTIC CLINIC PA
Practice address
3060 E Semoran Blvd #108
Apopka, FL 32703
Phone
(407) 788-9955
Fax
(407) 788-9966
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Yun Kim, DCNPI 1740459148
Title
Owner President
Phone
(407) 788-9955

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X FL CH0007351 FL Primary

Addresses

Primary practice location

3060 E Semoran Blvd #108
Apopka, FL 32703

Mailing address

3060 E Semoran Blvd #108
Apopka, FL 32703
Phone (407) 788-9955

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111111000561 FL Part B Supplier - Clinic/Group Practice 7012181894 Receives reassigned benefits from 1 practitioner
Practice locations: Altamonte Springs, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043351653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 E SEMORAN BLVD #108",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "32703",
            "telephone_number": "407-788-9955",
            "fax_number": "407-788-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 E SEMORAN BLVD #108",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "32703",
            "telephone_number": "407-788-9955",
            "fax_number": "407-788-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM CHIROPRACTIC CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "YUN",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "407-788-9955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "FL CH0007351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apopka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.