Individual provider Active NPI

Sangbumn Kim

  • Acupuncturist
  • Havertown, PA
National Provider Identifier
1144653064
Registry record updated Aug 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AK001084 Issued in PA
Practice address
525 W Chester Pike
#103A
Havertown, PA 19083-4500
Phone
(610) 789-3678
NPI assigned
Aug 14, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AK001084 PA Primary
Acupuncturist 171100000X 005122 NY

Addresses

Primary practice location

525 W Chester Pike
#103A
Havertown, PA 19083-4500

Mailing address

525 W Chester Pike
#103A
Havertown, PA 19083-4500
Phone (610) 789-3678

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

LicenseStateTypeSpecialty
AK001084PAMDAcupuncturist
005122NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sangbumn Kim Joy Acupuncture Acupuncturist CurrentSince Jun 16, 2024 Accepting new patients
Precision Health and Wellness Center LLC Past Accepting new patients

Locations

35 E Main St
Ste 5
Marlton, NJ 08053
Phone (856) 873-3719

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376438400000",
    "number": "1144653064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 W CHESTER PIKE",
            "address_2": "#103A",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190834500",
            "telephone_number": "610-789-3678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W CHESTER PIKE",
            "address_2": "#103A",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190834500",
            "telephone_number": "610-789-3678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SANGBUMN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-14",
        "last_updated": "2013-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "PA",
            "license": "AK001084",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "005122",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havertown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.