In-Soon Kim, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

MD039079L Issued in PA

Practice address

801 W Trenton Avenue
Morrisville, PA 19067-3516

Phone

(215) 736-9500

Fax

(215) 736-2779

NPI assigned

Nov 15, 2006

Last updated

Jun 29, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1366514275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 W TRENTON AVENUE",
            "city": "MORRISVILLE",
            "state": "PA",
            "postal_code": "190673516",
            "telephone_number": "215-736-9500",
            "fax_number": "215-736-2779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W TRENTON AVENUE",
            "city": "MORRISVILLE",
            "state": "PA",
            "postal_code": "190673516",
            "telephone_number": "215-736-9500",
            "fax_number": "215-736-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "IN-SOON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2010-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PA",
            "license": "MD039079L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2445432",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4276503",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1074081",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Xiomara Jimenez, FNP-BC
• Jrskv LLC (Burns Pharmacy)
• Yusuf Mujtaba Khan, MD
• Zeeshan Khan, DO
• Jimin Kim Lee
• Jennifer A Kirlin
• Kevin Koji Kita, D.C.
• Tracey Kosack
• April McGovern Kotwicki, D.C.
• KP Medix LLC

• General Practice Physician in Morrisville, PA
• Providers in Morrisville, PA by specialty
• General Practice Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.