NPIMap

Individual provider Active NPI

Ji Hwan Kim, M.D.

  • Family Medicine Physician
  • Orem, UT
National Provider Identifier
1194169441
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9845802-1205 Issued in UT
Practice address
505 W 400 N
Orem, UT 84057-1950
Phone
(801) 714-3450
Fax
(801) 714-3420
NPI assigned
Apr 17, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 9845802-1205 UT Primary

Addresses

Primary practice location

505 W 400 N
Orem, UT 84057-1950

Mailing address

505 W 400 N
Orem, UT 84057-1950
Phone (801) 714-3450

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ji.kim@direct.imail.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160824000372 UT Practitioner - Family Practice 2365737715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Eastern Virginia Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

505 W 400
Orem, UT 84057-1950
Phone (801) 714-3450

Hospital & facility affiliations

  • Intermountain Homecare Home Health Salt Lake Home health agency, South Jordan, UT, CCN 467030
  • Orem Community Hospital Hospital, Orem, UT, CCN 460043
  • Intermountain Health Utah Valley Hospital Hospital, Provo, UT, CCN 460001
  • American Fork Hospital Hospital, American Fork, UT, CCN 460023
  • Intermountain Health Spanish Fork Hospital Hospital, Spanish Fork, UT, CCN 460062

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Aug 1, 2016 Accepting new patients
Ihc Health Services Inc CurrentSince Aug 1, 2016 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

505 W 400 N
Orem, UT 84057
Phone (801) 357-7525

Organizations & group practices 4

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 7

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": "1366156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1194169441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 W 400 N",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840571950",
            "telephone_number": "801-714-3450",
            "fax_number": "801-714-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 W 400 N",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840571950",
            "telephone_number": "801-714-3450",
            "fax_number": "801-714-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JI",
        "middle_name": "HWAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-17",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "9845802-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ji.kim@direct.imail.org",
            "affiliation": "N",
            "address_1": "505 W 400 N",
            "city": "Orem",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840571950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orem, UT

Sources for this page

Verify at the official NPI Registry.