Individual provider Active NPI

Kevin Yunsang Kim, L.AC.

  • Acupuncturist
  • Charlotte, NC
National Provider Identifier
1396942058
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
377 Issued in NC
Practice address
8033 Corporate Center Dr Ste 400
Charlotte, NC 28226-4549
Phone
(704) 540-7471
Fax
(704) 540-7472
NPI assigned
Jun 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 377 NC Primary
Acupuncturist 171100000X AC 11172 CA

Addresses

Primary practice location

8033 Corporate Center Dr Ste 400
Charlotte, NC 28226-4549

Mailing address

8033 Corporate Center Dr Ste 400
Charlotte, NC 28226-4549
Phone (704) 540-7471

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

LicenseStateTypeSpecialty
AC 11172CAMDAcupuncturist
377NCMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1396942058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8033 CORPORATE CENTER DR STE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282264549",
            "telephone_number": "704-540-7471",
            "fax_number": "704-540-7472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8033 CORPORATE CENTER DR STE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282264549",
            "telephone_number": "704-540-7471",
            "fax_number": "704-540-7472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KEVIN",
        "middle_name": "YUNSANG",
        "name_prefix": "Dr.",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NC",
            "license": "377",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC 11172",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; 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.