NPIMap

Organization Active NPI

David E Kim MD PC

  • Internal Medicine Physician
  • Cartersville, GA
National Provider Identifier
1194919381
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
043675 Issued in GA
Legal business name
DAVID E KIM MD PC
Practice address
491 East Main St
Cartersville, GA 30121-3353
Phone
(770) 387-4512
Fax
(770) 334-3667
NPI assigned
Aug 30, 2007
Last updated
Oct 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Authorized official

Name
Mrs. Feliciana O Kim
Title
Office Manager
Phone
(678) 923-5049

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 043675 GA Primary

Addresses

Primary practice location

491 East Main St
Cartersville, GA 30121-3353

Mailing address

491 East Main St
Cartersville, GA 30121-3353
Phone (770) 387-4512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071113000153 GA Part B Supplier - Clinic/Group Practice 2163510983 Receives reassigned benefits from 3 practitioners
Practice locations: Cartersville, GA

National Provider Directory

National Provider Directory

Locations

962 Joe Frank Harris Pkwy SE
#104
Cartersville, GA 30120
Phone (770) 386-0090

Practitioners & affiliated clinicians

Practitioners 97

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 97

NPI Registry JSON

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697673600000",
    "number": "1194919381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "491 EAST MAIN ST",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301213353",
            "telephone_number": "770-387-4512",
            "fax_number": "770-334-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "491 EAST MAIN ST",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301213353",
            "telephone_number": "770-387-4512",
            "fax_number": "770-334-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID E KIM MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-30",
        "last_updated": "2023-10-19",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "FELICIANA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "678-923-5049",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "043675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; 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.