Charles C.S. Kim, M.D.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

015940 Issued in CT

Practice address

455 Lewis Ave
Suite 212
Meriden, CT 06451-2121

Phone

(203) 237-8855

Fax

(203) 237-8441

NPI assigned

Apr 14, 2007

Last updated

May 18, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hartford Healthcare Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Farmington, CT
  • NPI 1720140221
  NPD (past)
• Midstate Medical Group, PC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Meriden, CT
  • NPI 1356361315
  NPD (past)
• Midstate Medical Group, PC

  • Internal Medicine Physician
  • Southington, CT
  • NPI 1427089598

  Thoracic Surgery (Cardiothoracic Vascular Surgery)

  NPD (past)

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

{
    "created_epoch": "1176508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242604800000",
    "number": "1265657423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 LEWIS AVE",
            "address_2": "SUITE 212",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512121",
            "telephone_number": "203-237-8855",
            "fax_number": "203-237-8441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 LEWIS AVE",
            "address_2": "SUITE 212",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512121",
            "telephone_number": "203-237-8855",
            "fax_number": "203-237-8441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHARLES",
        "middle_name": "C.S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-14",
        "last_updated": "2009-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "015940",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CT",
            "license": "015940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arooba T Khan
• Zoheir Khan, MD
• Phirin Khen, PHARMD
• Humnah Khudayar, M.D.
• Joann Kiernan, PHD LPC
• Hanna Yoon Ji Kim, MS, LPC
• Inkwiy Kim, M.D.
• Ji Hyun Kim, D.D.S.
• Sharon Ann Kim, LCSW
• Jacqueline Kirby, MD

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Meriden, CT
• Providers in Meriden, CT by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.