Individual provider Active NPI

DO Za Kim

  • Behavior Technician
  • Greenwood, IN
National Provider Identifier
1376474346
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1777 W Stones Crossing Rd Ste 120
Greenwood, IN 46143-7899
Phone
(317) 953-8545
NPI assigned
May 27, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X IN Primary

Addresses

Primary practice location

1777 W Stones Crossing Rd Ste 120
Greenwood, IN 46143-7899

Mailing address

1777 W Stones Crossing Rd Ste 120
Greenwood, IN 46143-7899
Phone (317) 953-8545

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

NPI Registry JSON

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

{
    "created_epoch": "1779840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1376474346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 W STONES CROSSING RD STE 120",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461437899",
            "telephone_number": "317-953-8545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 W STONES CROSSING RD STE 120",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461437899",
            "telephone_number": "317-953-8545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DO",
        "middle_name": "ZA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-27",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; 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.