Active NPI
Mee Kyung Kim, D.C.
- Chiropractor
- Elkins Park, PA
National Provider Identifier
1104896216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 38MC00631100
- Practice address
- 7320 Old York Rd Ste 207a
Elkins Park, PA 19027-3007 - Phone
- (215) 500-2000
- Fax
- (888) 778-8180
- NPI assigned
- Jan 23, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 25MZ00173100 | NJ | |
| Chiropractor | 111N00000X | 38MC00631100 | NJ | Primary |
| Chiropractor | 111N00000X | DC009262 | PA |
Addresses
Primary practice location
7320 Old York Rd Ste 207a
Elkins Park, PA 19027-3007
Mailing address
804 Pleasant Valley Ave
Mount Laurel, NJ 08054-1222
Phone (215) 500-2000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38MC00631100 | Other | NJ | DC LICENSE |
| DC009262 | Other | PA | DC LICENSE |
| 25MZ00173100 | Other | NJ | LAC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081031000500 | NJ | Practitioner - Chiropractic | 2668406786 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MZ00173100 | NJ | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lusky Corp | Chiropractor | Current | Accepting new patients |
| Rapa Care, Inc | Chiropractor | Current | Accepting new patients |
| Sportsmed PT LLC | Chiropractor | Past | Accepting new patients |
Locations
1600 Parker Ave
Ste 1
Fort Lee, NJ 07024
Phone (201) 302-9993
Organizations & group practices 3
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.
-
- Chiropractor
- Elkins Park, PA
- NPI 1083842181
-
- Chiropractor
- Fort Lee, NJ
- NPI 1407441892
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723075200000",
"number": "1104896216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 PLEASANT VALLEY AVE",
"city": "MOUNT LAUREL",
"state": "NJ",
"postal_code": "080541222",
"telephone_number": "215-500-2000",
"fax_number": "215-500-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7320 OLD YORK RD STE 207A",
"city": "ELKINS PARK",
"state": "PA",
"postal_code": "190273007",
"telephone_number": "215-500-2000",
"fax_number": "888-778-8180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "MEE KYUNG",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-23",
"last_updated": "2024-08-08",
"certification_date": "2024-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NJ",
"license": "25MZ00173100",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NJ",
"license": "38MC00631100",
"primary": true
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "PA",
"license": "DC009262",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DC LICENSE",
"identifier": "38MC00631100",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DC LICENSE",
"identifier": "DC009262",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LAC",
"identifier": "25MZ00173100",
"state": "NJ"
}
],
"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 Aug 8, 2024; 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.