Active NPI
Grace G Kim, D.P.T.
- Physical Therapist
- Randolph, NJ
National Provider Identifier
1366787103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 035726-1
- Practice address
- 375 Dover Chester Rd
Randolph, NJ 07869-3910 - Phone
- (973) 252-9402
- NPI assigned
- Dec 5, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 035726-1 | NY | Primary |
Addresses
Primary practice location
375 Dover Chester Rd
Randolph, NJ 07869-3910
Mailing address
375 Dover Chester Rd
Randolph, NJ 07869-3910
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 035726-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354665600000",
"number": "1366787103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "375 DOVER CHESTER RD",
"city": "RANDOLPH",
"state": "NJ",
"postal_code": "078693910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "375 DOVER CHESTER RD",
"city": "RANDOLPH",
"state": "NJ",
"postal_code": "078693910",
"telephone_number": "973-252-9402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "GRACE",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-05",
"last_updated": "2012-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "035726-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Randolph, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.