Active NPI
Jimmy Kim, L.AC.
- Acupuncturist
- Redmond, OR
National Provider Identifier
1154544955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC00541
- Practice address
- 632 SW 6TH St
Suite 1
Redmond, OR 97756-2752 - Phone
- (541) 504-5939
- NPI assigned
- Apr 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC00541 | OR | Primary |
| Acupuncturist | 171100000X | AC6436 | CA |
Addresses
Primary practice location
632 SW 6TH St
Suite 1
Redmond, OR 97756-2752
Mailing address
632 SW 6TH St
Suite 1
Redmond, OR 97756-2752
Phone (541) 504-5939
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
| License | State | Type | Specialty |
|---|---|---|---|
| AC6436 | CA | MD | Acupuncturist |
| AC00541 | OR | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154544955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "632 SW 6TH ST",
"address_2": "SUITE 1",
"city": "REDMOND",
"state": "OR",
"postal_code": "977562752",
"telephone_number": "541-504-5939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "632 SW 6TH ST",
"address_2": "SUITE 1",
"city": "REDMOND",
"state": "OR",
"postal_code": "977562752",
"telephone_number": "541-504-5939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JIMMY",
"credential": "L.AC.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "OR",
"license": "AC00541",
"primary": true
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC6436",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redmond, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.