Active NPI
Sam Kim
- Occupational Therapist
- Tacoma, WA
National Provider Identifier
1134364086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1285
- Practice address
- Madigan Army Medical Center (Mamc) 9040 Jackson Ave
Tacoma, WA 98431-0001 - Phone
- (253) 968-9009
- NPI assigned
- Dec 6, 2008
- Last updated
- Jul 12, 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1285 | NE | Primary |
Addresses
Primary practice location
Madigan Army Medical Center (Mamc) 9040 Jackson Ave
Tacoma, WA 98431-0001
Mailing address
1114 Cole Creek Dr
Omaha, NE 68114-3042
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720742400000",
"number": "1134364086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1114 COLE CREEK DR",
"city": "OMAHA",
"state": "NE",
"postal_code": "681143042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MADIGAN ARMY MEDICAL CENTER (MAMC) 9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984310001",
"telephone_number": "253-968-9009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-12-06",
"last_updated": "2024-07-12",
"certification_date": "2024-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NE",
"license": "1285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.