Individual provider Active NPI

Sang H Kim, D.C.

  • Chiropractor
  • Blue Bell, PA
National Provider Identifier
1437124104
Registry record updated Sep 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC006298L Issued in PA
Practice address
704 Dekalb Pike
Blue Bell, PA 19422-1214
Phone
(610) 313-3185
Fax
(610) 313-3187
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC006298L PA Primary

Addresses

Primary practice location

704 Dekalb Pike
Blue Bell, PA 19422-1214

Mailing address

704 Dekalb Pike
Blue Bell, PA 19422-1214
Phone (610) 313-3185

Other identifiers 1

IdentifierTypeStateIssuer
7827654OtherPAAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060214000228 PA Practitioner - Chiropractic 3072528298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1400 Willow Ave
Suite B1
Elkins Park, PA 19027-3100
Phone (215) 782-1235

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kim Chiropractic & Rehab Center - Elkins Park Inc Chiropractor CurrentSince Apr 10, 2017 Accepting new patients
Kim Chiropractic & Rehab Center - Blue Bell Inc Chiropractor PastSince Aug 7, 2011 Accepting new patients
Kim Chiropractic & Rehab Center Chiropractor Past Accepting new patients

Locations

1400 Willow Ave
Ste B1
Elkins Park, PA 19027
Phone (215) 635-1160

921 W Cheltenham Ave
Melrose Park, PA 19027
Phone (215) 635-4902

Organizations & group practices 3

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1437124104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 DEKALB PIKE",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194221214",
            "telephone_number": "610-313-3185",
            "fax_number": "610-313-3187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 DEKALB PIKE",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194221214",
            "telephone_number": "610-313-3185",
            "fax_number": "610-313-3187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SANG",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC006298L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7827654",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Bell, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.