Individual provider Active NPI

Christopher Donghyun Kim, MD

  • Family Medicine Physician
  • Haymarket, VA
National Provider Identifier
1255820056
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101282164 Issued in VA
Practice address
15195 Heathcote Blvd Ste 140
Haymarket, VA 20169-6243
Phone
(571) 284-4370
NPI assigned
May 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 30084 WV
Family Medicine Physician 207Q00000X DR.0067011 CO
Family Medicine Physician 207Q00000X 0101282164 VA Primary

Addresses

Primary practice location

15195 Heathcote Blvd Ste 140
Haymarket, VA 20169-6243

Mailing address

PO Box 748613
Atlanta, GA 30384-8613
Phone (434) 295-1000

Other names 1

  • Dong Hyun Kim Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241014004026 VA Practitioner - Family Practice 0446500227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Uva Community Health Medical Group LLCGroup PAC ID 4688587967, 339 clinicians

Practice addresses (Care Compare)

15195 Heathcote Blvd
Suite 140
Haymarket, VA 20169-6243
Phone (571) 284-4370

Hospital & facility affiliations

  • Uva Health Haymarket Medical Center Hospital, Haymarket, VA, CCN 490144
  • Uva Health Prince William Medical Center Hospital, Manassas, VA, CCN 490045
  • Fauquier Hospital Hospital, Warrenton, VA, CCN 490023

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101282164VAMDFamily Medicine Physician
30084WVMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Uva Community Health Medical Group, LLC CurrentSince Sep 30, 2024 Accepting new patients
Uva Community Health Medical Group, LLC Family Medicine Past Accepting new patients

Locations

4105 Lewis and Clark Dr
Charlottesvle, VA 22911

15195 Heathcote Blvd
Ste 140
Haymarket, VA 20169
Phone (571) 284-4370

Interoperability endpoints

  • Direct secure messaging: ckim645786@direct.healthsystem.virginia.edu

Organizations & group practices 2

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 3

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": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1255820056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748613",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848613",
            "telephone_number": "434-295-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15195 HEATHCOTE BLVD STE 140",
            "city": "HAYMARKET",
            "state": "VA",
            "postal_code": "201696243",
            "telephone_number": "571-284-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHRISTOPHER",
        "middle_name": "DONGHYUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-07",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WV",
            "license": "30084",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0067011",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101282164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DONG",
            "last_name": "KIM",
            "middle_name": "HYUN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Haymarket, VA

Sources for this page

Verify at the official NPI Registry.