Individual provider Active NPI

Paul S Kim, M.D.

  • Hematology & Oncology Physician
  • Fletcher, NC
National Provider Identifier
1114923299
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
20000490 Issued in NC
Practice address
3159 Hendersonville Road
Fletcher, NC 28732
Phone
(828) 687-9993
Fax
(828) 687-2491
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 20000490 NC Primary

Addresses

Primary practice location

3159 Hendersonville Road
Fletcher, NC 28732

Mailing address

PO Box 38
Fletcher, NC 28732-0038
Phone (828) 687-9993

Other identifiers 4

IdentifierTypeStateIssuer
1259COtherNCBLUE CROSS BLUE SHIELD
56142OtherNCCOMMERCIAL INSURANCE
2280204BOtherNCMEDICARE
891259CMedicaidNC

Other names 1

  • Dr. Sung U Kim Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041227000251 NC Practitioner - Medical OncologyPractitioner - Internal Medicine 5294793048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Internal Medicine
Education
Ohio State University College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3159 Hendersonville Rd
Fletcher, NC 28732-8235
Phone (828) 687-9993

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20000490NCMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Hematology and Oncology Hematology & Oncology CurrentSince Nov 1, 2004 Accepting new patients

Locations

3159 Hendersonville Rd
Fletcher, NC 28732
Phone (828) 687-9993

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1114923299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38",
            "city": "FLETCHER",
            "state": "NC",
            "postal_code": "287320038",
            "telephone_number": "828-687-9993",
            "fax_number": "828-687-2491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3159 HENDERSONVILLE ROAD",
            "city": "FLETCHER",
            "state": "NC",
            "postal_code": "28732",
            "telephone_number": "828-687-9993",
            "fax_number": "828-687-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "PAUL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "20000490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1259C",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL INSURANCE",
            "identifier": "56142",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "2280204B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891259C",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUNG",
            "last_name": "KIM",
            "middle_name": "U",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fletcher, NC

Sources for this page

Verify at the official NPI Registry.