Jae Chul Kim, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

JK040509 Issued in MI

Practice address

5031 Villa Linde Pkwy
Ste 20
Flint, MI 48532-3448

Phone

(810) 732-2975

Fax

(810) 732-0116

NPI assigned

Jul 18, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Psychiatry

Education

Other, 1963

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Jae C Kim, MD, PC

  • Psychiatry Physician
  • Flint, MI
  • NPI 1861666166

  MI

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1295734762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5031 VILLA LINDE PKWY",
            "address_2": "STE 20",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323448",
            "telephone_number": "810-732-2975",
            "fax_number": "810-732-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5031 VILLA LINDE PKWY",
            "address_2": "STE 20",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323448",
            "telephone_number": "810-732-2975",
            "fax_number": "810-732-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JAE",
        "middle_name": "CHUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "JK040509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1579441",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corbin A Killam, RN
• Austyn Baylee Killebrew
• Ronald Joseph Killian
• Catheline Kim, LLMSW
• Haesook S Kim, MD
• Jaehee Kim, LLMSW
• Minjung Minny Kim, DO
• Kimberly Ann Alabi-Isama
• Joel P Kimelman, DO
• Jennifer Kimmel, LLMSW

• All providers in Flint, MI
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.