Active NPI
David T Kim
- Physical Therapist
- Honolulu, HI
National Provider Identifier
1366832271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4190
- Practice address
- 5113 Maunalani Cir
Honolulu, HI 96816-4019 - Phone
- (808) 732-0771
- NPI assigned
- Jan 30, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3002 | NV | |
| Physical Therapist | 225100000X | 4190 | HI | Primary |
Addresses
Primary practice location
5113 Maunalani Cir
Honolulu, HI 96816-4019
Mailing address
1147 Point Success Ave
Henderson, NV 89014-7885
Phone (312) 354-0876
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 |
|---|---|---|---|
| 4190 | HI | MD | Physical Therapist |
| 3002 | NV | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468886400000",
"number": "1366832271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1147 POINT SUCCESS AVE",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890147885",
"telephone_number": "312-354-0876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5113 MAUNALANI CIR",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968164019",
"telephone_number": "808-732-0771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "DAVID",
"middle_name": "T",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-01-30",
"last_updated": "2016-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NV",
"license": "3002",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "HI",
"license": "4190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.