Individual provider Active NPI

Lawrence Kim, M.D

  • Gastroenterology Physician
  • Lone Tree, CO
National Provider Identifier
1275647414
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
36975 Issued in CO
Practice address
10103 Ridgegate Pkwy
Ste 312
Lone Tree, CO 80124-5520
Phone
(303) 788-8888
Fax
(866) 456-4594
NPI assigned
Aug 17, 2006
Last updated
Oct 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 36975 CO Primary

Addresses

Primary practice location

10103 Ridgegate Pkwy
Ste 312
Lone Tree, CO 80124-5520

Mailing address

10103 Ridge Gate Parkway
Ste 312
Lone Tree, CO 80124
Phone (303) 788-8888

Other identifiers 2

IdentifierTypeStateIssuer
01369750MedicaidCO
100012740OtherCOMEDICARE RAILROAD

Other names 1

  • Dr. Lawrence Kim Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20041228000695 CO Practitioner - Gastroenterology 2961392402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Johns Hopkins University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10103 Ridgegate Pkwy
Suite 312
Lone Tree, CO 80124-5525
Phone (303) 788-8888

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy54
Upper gastrointestinal (GI) endoscopy for acid reflux58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36975COMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Denver Gastroenterology, PC Gastroenterology CurrentSince Dec 10, 2021 Accepting new patients

Locations

3911 Ambrosia St
Ste 201
Castle Rock, CO 80109
Phone (303) 788-8888

10103 Ridgegate Pkwy
Ste 312
Lone Tree, CO 80124
Phone (303) 788-8888

Interoperability endpoints

  • Direct secure messaging: lawrence.kim.1@3461.direct.athenahealth.com

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

Hospital & facility affiliations 1

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1275647414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10103 RIDGE GATE PARKWAY",
            "address_2": "STE 312",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "80124",
            "telephone_number": "303-788-8888",
            "fax_number": "866-456-4594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10103 RIDGEGATE PKWY",
            "address_2": "STE 312",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245520",
            "telephone_number": "303-788-8888",
            "fax_number": "866-456-4594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CO",
            "license": "36975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01369750",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "100012740",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAWRENCE",
            "last_name": "KIM",
            "prefix": "DR.",
            "credential": "M.D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lone Tree, CO

Sources for this page

Verify at the official NPI Registry.