Active NPI
Nam Hoon Kim, D.C.
- Chiropractor
- Portland, OR
National Provider Identifier
1164820148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5599
- Practice address
- 18206 SE Stark St
Portland, OR 97233-4863 - Phone
- (360) 521-5676
- Fax
- (833) 517-1922
- NPI assigned
- Dec 8, 2014
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH60514800 | WA | |
| Chiropractor | 111N00000X | 5599 | OR | Primary |
Addresses
Primary practice location
18206 SE Stark St
Portland, OR 97233-4863
Mailing address
17405 SE Stark St
Portland, OR 97233-4500
Phone (360) 521-5576
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251006002829 | WA | Practitioner - Chiropractic | 6507363710 | Practice locations: Vancouver, WA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Western States College of Chiropractic, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
12535 SE 131St CT
Happy Valley, OR 97086-1684
13521 SE 3Rd Way
Suite 200
Vancouver, WA 98684-6909
Phone (360) 909-5032
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5599 | OR | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Impact Chiropractic | Chiropractor | Current | Accepting new patients |
| Impact Chiropractic | Current | Accepting new patients | |
| Namu Chiropractic | Chiropractor | Past | Accepting new patients |
| Duncan Health Centers, LLC | Past | Accepting new patients | |
| Nam Hoon Kim PC | Chiropractor | Past | Accepting new patients |
Locations
18206 SE Stark St
Portland, OR 97233
Phone (360) 521-5576
Organizations & group practices 5
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.
-
- Chiropractor
- Portland, OR
- NPI 1851161921
-
- Rehabilitation Clinic/Center
- Portland, OR
- NPI 1972364735
-
- Chiropractor
- Beaverton, OR
- NPI 1336646744
-
- Chiropractor
- Vancouver, WA
- NPI 1083478580
-
- Pain Clinic/Center
- Beaverton, OR
- NPI 1669875480
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715299200000",
"number": "1164820148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17405 SE STARK ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972334500",
"telephone_number": "360-521-5576",
"fax_number": "833-517-1922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18206 SE STARK ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972334863",
"telephone_number": "360-521-5676",
"fax_number": "833-517-1922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "NAM",
"middle_name": "HOON",
"name_prefix": "Mr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-12-08",
"last_updated": "2024-05-10",
"certification_date": "2024-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "CH60514800",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "5599",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.