Active NPI
Kiku E Kim, MD
- Psychiatry Physician
- Waipahu, HI
National Provider Identifier
1114997251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 35081898K
- Practice address
- 94-229 Waipahu Depot St Ste 500
Waipahu, HI 96797-3035 - Phone
- (503) 841-5065
- Fax
- (866) 824-0948
- NPI assigned
- Jan 23, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 35081898K | OH | Primary |
Addresses
Primary practice location
94-229 Waipahu Depot St Ste 500
Waipahu, HI 96797-3035
Mailing address
94-229 Waipahu Depot St Ste 500
Waipahu, HI 96797-3035
Phone (503) 841-5065
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2242342 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 5, 2021 through Jul 5, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35081898K | OH | MD | Psychiatry Physician |
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": "1640736000000",
"number": "1114997251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94-229 WAIPAHU DEPOT ST STE 500",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967973035",
"telephone_number": "503-841-5065",
"fax_number": "866-824-0948"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94-229 WAIPAHU DEPOT ST STE 500",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967973035",
"telephone_number": "503-841-5065",
"fax_number": "866-824-0948"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "KIKU",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-23",
"last_updated": "2021-12-29",
"certification_date": "2021-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OH",
"license": "35081898K",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2242342",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waipahu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.