NPIMap

Individual provider Active NPI

Sungnam Joe, M.D.

  • Internal Medicine Physician
  • Kingman, AZ
National Provider Identifier
1376538389
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
24593 Issued in AZ
Practice address
1510 N Stockton Hill Rd
Kingman, AZ 86401-5173
Phone
(928) 753-1177
Fax
(928) 718-4501
NPI assigned
Sep 15, 2005
Last updated
Apr 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 24593 AZ Primary

Addresses

Primary practice location

1510 N Stockton Hill Rd
Kingman, AZ 86401-5173

Mailing address

1510 N Stockton Hill Rd
Kingman, AZ 86401-5173
Phone (928) 753-1177

Other identifiers 2

IdentifierTypeStateIssuer
363151MedicaidAZ
24593OtherAZLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100224000168 AZ Practitioner - Internal Medicine 2062556376 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Country Healthcare IncGroup PAC ID 8820981053, shared by 3 NPIs, 20 clinicians

Practice addresses (Care Compare)

2920 N 4TH St
Flagstaff, AZ 86004-1816

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.85 of 100Reported as group
Quality
84.49
Promoting interoperability
83
Improvement activities
40
Cost
79.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24593AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Country Healthcare, Inc. CurrentSince Mar 1, 2024 Accepting new patients
North Country Healthcare, Inc. CurrentSince Mar 1, 2024 Accepting new patients
Kingman Healthcare, Inc Current Accepting new patients
Kingman Healthcare, Inc Internal Medicine CurrentSince Oct 19, 1998 Accepting new patients
Kingman Healthcare, Inc CurrentSince Oct 19, 1998 Accepting new patients

Locations

2500 N Rose St
Flagstaff, AZ 86004
Phone (928) 213-6121

1510 N Stockton Hill Rd
Kingman, AZ 86401
Phone (928) 753-1177

1739 E Beverly Ave
Ste 200
Kingman, AZ 86409
Phone (928) 263-4722

1739 E Beverly Ave
Ste 201
Kingman, AZ 86409
Phone (928) 681-8704

2226 Hualapai Mountain Rd
Ste 101
Kingman, AZ 86401
Phone (928) 681-8703

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

620 Lee St
Winslow, AZ 86047
Phone (928) 288-8700

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1376538389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 N STOCKTON HILL RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864015173",
            "telephone_number": "928-753-1177",
            "fax_number": "928-718-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 N STOCKTON HILL RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864015173",
            "telephone_number": "928-753-1177",
            "fax_number": "928-718-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOE",
        "first_name": "SUNGNAM",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "24593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363151",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "24593",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingman, AZ

Sources for this page

Verify at the official NPI Registry.