Individual provider Active NPI

Regina J H Kim, MD

  • Family Medicine Physician
  • Kent, WA
National Provider Identifier
1386746311
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61469999 Issued in WA
Practice address
26004 104TH Ave SE
Kent, WA 98030-7677
Phone
(425) 251-4040
Fax
(877) 514-9952
NPI assigned
Sep 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036112620 IL
Family Medicine Physician 207Q00000X MD61469999 WA Primary

Addresses

Primary practice location

26004 104TH Ave SE
Kent, WA 98030-7677

Mailing address

26004 104TH Ave SE
Kent, WA 98030-7677
Phone (425) 251-4040

Other practice location 1

150 E Huron St Ste 1100
Chicago, IL 60611-2948
Phone (312) 926-3627

Other practice location 2

150 E Huron St Ste 1100
Chicago, IL 60611-2948
Phone (312) 926-0033

Other identifiers 1

IdentifierTypeStateIssuer
036112620MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250117002771 WA Practitioner - Family Practice 0446289193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Chicago, Pritzker School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

26004 104TH Ave SE
Suite 101
Kent, WA 98030-7677
Phone (425) 251-4050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036112620ILMDFamily Medicine Physician
MD61469999WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Mar 15, 2025 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Mar 15, 2025 Accepting new patients
The Board of Trustees of the University of Illinois Past Accepting new patients
Howard Brown Health Center Past Accepting new patients
Kaiser Foundation Health Plan of Washington PastSince Jan 19, 2025 Accepting new patients
The Board of Trustees of the University of Illinois Family Medicine Past Accepting new patients
Howard Brown Health Center Past Accepting new patients

Locations

26004 104th Ave SE
Ste 101
Kent, WA 98030
Phone (425) 251-4040

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: rkim4583358@ghc.direct-ci.net

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1386746311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26004 104TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307677",
            "telephone_number": "425-251-4040",
            "fax_number": "877-514-9952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26004 104TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307677",
            "telephone_number": "425-251-4040",
            "fax_number": "877-514-9952"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 E Huron St Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112948",
            "country_code": "US",
            "telephone_number": "312-926-3627",
            "fax_number": "312-926-5444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 E Huron St Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112948",
            "country_code": "US",
            "telephone_number": "312-926-0033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "REGINA",
        "middle_name": "J H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036112620",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61469999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112620",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "26004 104th Ave SE",
            "city": "Kent",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980307677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

Verify at the official NPI Registry.