NPIMap

Organization Active NPI

Tri Kim LLC

Doing business as Spine Connection Wellness Center

  • Chiropractor
  • Fulton, MD
National Provider Identifier
1285155085
Registry record updated Oct 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S03904 Issued in MD
Legal business name
TRI KIM LLC
Doing business as
Spine Connection Wellness Center
Practice address
11820 W Market PL Ste K
Fulton, MD 20759-2421
Phone
(240) 832-7993
NPI assigned
Jun 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2017

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

Authorized official

Name
John Yongmin Kim, DC
Title
Owner
Phone
(301) 362-3609

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X S03904 MD Primary

Addresses

Primary practice location

11820 W Market PL Ste K
Fulton, MD 20759-2421

Mailing address

7445 Saint Margarets Blvd
Hanover, MD 21076-2135

Other names 1

  • Spine Connection Wellness Center Doing business as

National Provider Directory

National Provider Directory

Locations

11820 W Market Pl
Ste K
Fulton, MD 20759
Phone (301) 362-3609

NPI Registry JSON

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507766400000",
    "number": "1285155085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7445 SAINT MARGARETS BLVD",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210762135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11820 W MARKET PL STE K",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592421",
            "telephone_number": "240-832-7993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI KIM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-30",
        "last_updated": "2017-10-12",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "YONGMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-362-3609",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S03904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spine Connection Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fulton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2017; 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.