Kenneth Keisung Kim, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

835 Issued in HI

Practice address

803 Hahaione St
Honolulu, HI 96825-1028

Phone

(808) 285-8906

NPI assigned

May 19, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Sterling Adult Day Services

  • Adult Day Care Clinic/Center
  • Colorado Springs, CO
  • NPI 1497927529
  NPD (past)
• Sterling Medical Associates

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Cincinnati, OH
  • NPI 1336226729
  NPD (past)

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1225295181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 HAHAIONE ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968251028",
            "telephone_number": "808-285-8906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 HAHAIONE ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968251028",
            "telephone_number": "808-285-8906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1441 Kapiolani Blvd Ste 1600",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968144407",
            "country_code": "US",
            "telephone_number": "808-432-7600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "KENNETH",
        "middle_name": "KEISUNG",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-19",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "HI",
            "license": "835",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodhim/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1441 Kapiolani Blvd Ste 1600",
            "city": "Honolulu",
            "state": "HI",
            "country_code": "US",
            "postal_code": "968144407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jin Kim, D.C.
• Jin Hee Kim, PHARM D
• Jisu Kim, DDS
• Jung H Kim, MD
• Karla Kim, MFT
• Kenny Kim
• Kyung Moo Kim
• Kyung Taek Kim, L.AC, DIPL.AC, O.M
• Lawrence Kim
• Leon Yongseok Kim, APRN-RX

• Clinical Psychologist in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Clinical Psychologist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.