Organization Active NPI

Caroline Kim, MD, PLLC

  • Surgery Physician
  • Houston, TX
National Provider Identifier
1255944260
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
CAROLINE KIM, MD, PLLC
Practice address
2222 Greenhouse Rd Ste 1800
Houston, TX 77084-7855
Phone
(713) 464-2100
Fax
(281) 392-2032
NPI assigned
Aug 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Authorized official

Name
Dr. Caroline Kim, MDNPI 1457595530
Title
Owner
Phone
(615) 498-0537

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

2222 Greenhouse Rd Ste 1800
Houston, TX 77084-7855

Mailing address

2222 Greenhouse Rd Ste 1800
Houston, TX 77084-7855
Phone (713) 464-2100

Other practice location 1

929 Gessner Rd Ste 2470
Houston, TX 77024-2841
Phone (713) 932-1001

Other identifiers 1

IdentifierTypeStateIssuer
Q5456OtherTXGENERAL SURGERY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201119000973 TX Part B Supplier - Clinic/Group Practice 4587075791 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

929 Gessner Rd
Ste 2470
Houston, TX 77024
Phone (713) 932-1001

2222 Greenhouse Rd
Ste 1800
Houston, TX 77084
Phone (713) 463-4005

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1255944260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 GREENHOUSE RD STE 1800",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770847855",
            "telephone_number": "713-464-2100",
            "fax_number": "281-392-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 GREENHOUSE RD STE 1800",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770847855",
            "telephone_number": "713-464-2100",
            "fax_number": "281-392-2032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "929 Gessner Rd Ste 2470",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770242841",
            "country_code": "US",
            "telephone_number": "713-932-1001",
            "fax_number": "713-932-0037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAROLINE KIM, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-28",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-498-0537",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL SURGERY",
            "identifier": "Q5456",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.