Kim Podiatry LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

KIM PODIATRY LLC

Practice address

4701 Randolph Rd Ste 103
Rockville, MD 20852-2260

Phone

(216) 217-9322

NPI assigned

Jan 27, 2025

Organization subpart

No

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

Authorized official

Name

Chang Yong Kim, DPMNPI 1902330400

Title

Owner

Phone

(240) 206-6274

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, DC3 enrollments

Enrollment records 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chang Yong Kim, DPM

  • Podiatrist
  • Rockville, MD
  • NPI 1902330400

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1194538918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 RANDOLPH RD STE 103",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522260",
            "telephone_number": "240-206-6274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 RANDOLPH RD STE 103",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522260",
            "telephone_number": "216-217-9322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "CHANG YONG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-206-6274",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrienne Kiebler
• Elizabeth Kiely
• Emmanuel Kila
• Tamara L. Kile, D.O.
• Wendy Walker Kilmer
• Alisa Kim, M.D.
• Allan S Kim, D.M.D.
• Ana Kim
• Andrew Kwanhee Kim, PHARM.D.
• Annie Kim

• Podiatrist in Rockville, MD
• Providers in Rockville, MD by specialty
• Podiatrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.