Active NPI
Seung Kim
- Pediatric Gastroenterology Physician
- Cincinnati, OH
National Provider Identifier
1114770864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Gastroenterology Physician
- License
- 57.255872
- Practice address
- 3333 Burnet Ave
Cincinnati, OH 45229-3026 - Phone
- (513) 636-4200
- NPI assigned
- Apr 10, 2024
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Gastroenterology Physician | 2080P0206X | 57.255872 | OH | Primary |
Addresses
Primary practice location
3333 Burnet Ave
Cincinnati, OH 45229-3026
Mailing address
10608 Deercreek LN
Cincinnati, OH 45249-3506
Phone (513) 818-7586
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57.255872 | OH | MD | Pediatric Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712707200000",
"number": "1114770864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10608 DEERCREEK LN",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452493506",
"telephone_number": "513-818-7586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 BURNET AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452293026",
"telephone_number": "513-636-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SEUNG",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-04-10",
"last_updated": "2024-04-10",
"certification_date": "2024-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "OH",
"license": "57.255872",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.