Active NPI
Karen Michelle Kim, MD
- Pediatrics Physician
- Pooler, GA
National Provider Identifier
1144213018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 047470
- Practice address
- 406 Gray St
Suite 200
Pooler, GA 31322-2604 - Phone
- (912) 748-4527
- Fax
- (912) 748-9016
- NPI assigned
- Aug 25, 2005
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 047470 | GA | Primary |
Addresses
Primary practice location
406 Gray St
Suite 200
Pooler, GA 31322-2604
Mailing address
PO Box 668
Pooler, GA 31322-0668
Phone (912) 748-4527
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 047470 | GA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids First Pediatrics of Georgia, P.C. | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BABJAA/Endpoint/BABJAA
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.
-
- Pediatrics Physician
- Pooler, GA
- NPI 1326269598
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1144213018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 668",
"city": "POOLER",
"state": "GA",
"postal_code": "313220668",
"telephone_number": "912-748-4527",
"fax_number": "912-748-9016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "406 GRAY ST",
"address_2": "SUITE 200",
"city": "POOLER",
"state": "GA",
"postal_code": "313222604",
"telephone_number": "912-748-4527",
"fax_number": "912-748-9016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "KAREN",
"middle_name": "MICHELLE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-25",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "047470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pooler, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.