Active NPI
John Tae-Kwon Kim, M.S., L.AC.
- Acupuncturist
- Trophy Club, TX
National Provider Identifier
1376837559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC01261
- Practice address
- 501 Trophy Lake Dr
Suite 322
Trophy Club, TX 76262-5222 - Phone
- (214) 643-9940
- NPI assigned
- Jun 5, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC01261 | TX | Primary |
Addresses
Primary practice location
501 Trophy Lake Dr
Suite 322
Trophy Club, TX 76262-5222
Mailing address
4600 N Josey LN
# 717
Carrollton, TX 75010-4616
Phone (615) 415-1876
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC01261 | TX | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307232000000",
"number": "1376837559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4600 N JOSEY LN",
"address_2": "# 717",
"city": "CARROLLTON",
"state": "TX",
"postal_code": "750104616",
"telephone_number": "615-415-1876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 TROPHY LAKE DR",
"address_2": "SUITE 322",
"city": "TROPHY CLUB",
"state": "TX",
"postal_code": "762625222",
"telephone_number": "214-643-9940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JOHN",
"middle_name": "TAE-KWON",
"name_prefix": "Mr.",
"credential": "M.S., L.AC.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-05",
"last_updated": "2011-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "TX",
"license": "AC01261",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Trophy Club, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.