NPIMap

Individual provider Active NPI

John Kim, DO

  • Hospitalist Physician
  • Henderson, NV
National Provider Identifier
1104209550
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
DO3595 Issued in NV
Practice address
3001 Saint Rose Pkwy
Henderson, NV 89052-3839
Phone
(702) 492-8592
Fax
(702) 492-8045
NPI assigned
Jul 2, 2015
Last updated
Jun 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO3595 NV
Hospitalist Physician 208M00000X DO3595 NV Primary

Addresses

Primary practice location

3001 Saint Rose Pkwy
Henderson, NV 89052-3839

Mailing address

PO Box 33269
Phoenix, AZ 85067-3269
Phone (602) 406-4786

Other practice location 1

102 E Lake Mead Pkwy
Henderson, NV 89015-5575
Phone (702) 492-8592

Other practice location 2

8280 W Warm Springs Rd
Las Vegas, NV 89113-3612
Phone (702) 492-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240614003057 NV Practitioner - Internal Medicine 9830435593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dignity Health Medical Group Nevada LLCGroup PAC ID 1254571896, 127 clinicians

Practice addresses (Care Compare)

8689 W Charleston Blvd
Suite 105
Las Vegas, NV 89117-5485
Phone (702) 304-5900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
63.87
Promoting interoperability
96
Improvement activities
40
Cost
76.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Group Nevada, LLC CurrentSince May 4, 2024 Accepting new patients
Dignity Health Past Accepting new patients

Locations

8689 W Charleston Blvd
Ste 105
Las Vegas, NV 89117
Phone (702) 304-5900

Organizations & group practices 2

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

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1104209550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 SAINT ROSE PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523839",
            "telephone_number": "702-492-8592",
            "fax_number": "702-492-8045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 E Lake Mead Pkwy",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890155575",
            "country_code": "US",
            "telephone_number": "702-492-8592",
            "fax_number": "702-492-8045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8280 W Warm Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891133612",
            "country_code": "US",
            "telephone_number": "702-492-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOHN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-02",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "DO3595",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NV",
            "license": "DO3595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.