Individual provider Active NPI

Christopher Kim, M.D.

  • Diagnostic Radiology Physician
  • Murray, UT
National Provider Identifier
1184039059
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
12805646-1205 Issued in UT
Practice address
5217 S State St Ste 200
Murray, UT 84107-4812
Phone
(801) 313-4118
NPI assigned
Jun 30, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A139439 CA
Diagnostic Radiology Physician 2085R0202X 12805646-1205 UT Primary

Addresses

Primary practice location

5217 S State St Ste 200
Murray, UT 84107-4812

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (707) 521-4480

Other practice location 1

200 W Arbor Dr
#8756
San Diego, CA 92103-9000
Phone (310) 908-8552

Other practice location 2

2449 Summerfield Rd
Santa Rosa, CA 95405-7815
Phone (707) 523-2666

Other practice location 3

3883 Airway Dr Ste 100
Santa Rosa, CA 95403-1672
Phone (707) 521-4480

Other identifiers 1

IdentifierTypeStateIssuer
A139439OtherCASTATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220629003376 UT Practitioner - Diagnostic Radiology 2163716986 Reassigns benefits to 2 organizations
I20260225003040 WA Practitioner - Diagnostic Radiology 2163716986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Cincinnati College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians
Tellica Imaging - Washington LLCGroup PAC ID 0648757393, 50 clinicians

Practice addresses (Care Compare)

1333 N Main St
Suite 1
Cedar City, UT 84721-9314
Phone (435) 868-5000

1380 E Medical Ctr Dr
St George, UT 84790-2123
Phone (435) 251-1000

2941 S 38TH St
Suite E
Tacoma, WA 98409-5647
Phone (253) 534-8689

5121 S Cottonwood St
Murray, UT 84107-5701

Hospital & facility affiliations

  • Intermountain Medical Center Hospital, Murray, UT, CCN 460010
  • Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004
  • Intermountain Health Riverton Hospital Hospital, Riverton, UT, CCN 460058
  • Intermountain Health Alta View Hospital Hospital, Sandy, UT, CCN 460044
  • Intermountain Health Cedar City Hospital Hospital, Cedar City, UT, CCN 460007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
139439CAMDMarriage & Family Therapist
A139439CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Diagnostic Radiology CurrentSince Jul 1, 2022 Accepting new patients
Ihc Health Services Inc Family Medicine Current Accepting new patients
Tellica Imaging, LLC CurrentSince Aug 1, 2022 Accepting new patients
Tellica Imaging, LLC CurrentSince Nov 7, 2023 Accepting new patients
Tellica Imaging, LLC CurrentSince Aug 1, 2022 Accepting new patients
Tellica Imaging - Washington LLC Diagnostic Radiology CurrentSince Jan 12, 2026 Accepting new patients
Tellica Imaging, LLC Diagnostic Radiology CurrentSince Nov 7, 2023 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jul 1, 2022 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jan 12, 2024 Accepting new patients
Tellica Imaging, LLC CurrentSince Apr 13, 2023 Accepting new patients
Tellica Imaging - Washington LLC Diagnostic Radiology PastSince Oct 5, 2025 Accepting new patients

Locations

1887 Whitney Mesa Dr
Henderson, NV 89014
Phone (702) 819-0368

5217 S State St
Salt Lake City, UT 84107
Phone (801) 313-4110

5217 S State St
Ste 200
Salt Lake City, UT 84107
Phone (208) 417-5100

36 S Street St
Ste 2200
Salt Lake Cty, UT 84111
Phone (385) 622-0669

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

421 E Main St
Auburn, WA 98002
Phone (253) 204-2530

2941 S 38th St
Ste E
Tacoma, WA 98409
Phone (253) 534-8689

Interoperability endpoints

  • Direct secure messaging: ckim550941@hisp.ehr.sutterhealth.org

Organizations & group practices 11

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1184039059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "707-521-4480",
            "fax_number": "707-521-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5217 S STATE ST STE 200",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841074812",
            "telephone_number": "801-313-4118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Arbor Dr",
            "address_2": "#8756",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921039000",
            "country_code": "US",
            "telephone_number": "310-908-8552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2449 Summerfield Rd",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954057815",
            "country_code": "US",
            "telephone_number": "707-523-2666",
            "fax_number": "707-523-3399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3883 Airway Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954031672",
            "country_code": "US",
            "telephone_number": "707-521-4480",
            "fax_number": "707-521-4460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHRISTOPHER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-30",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A139439",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "12805646-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "A139439",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.