Individual provider Active NPI

Un Ju Kim

  • Cardiovascular Disease Physician
  • Clemmons, NC
National Provider Identifier
1447543632
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
2017-01151 Issued in NC
Practice address
7114 Village Medical Cir
Clemmons, NC 27012-8004
Phone
(336) 893-2440
Fax
(336) 893-2470
NPI assigned
May 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 2017-01151 NC Primary

Addresses

Primary practice location

7114 Village Medical Cir
Clemmons, NC 27012-8004

Mailing address

PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 277-2000

Other practice location 1

186 Kimel Park Dr
Winston Salem, NC 27103-6946
Phone (336) 277-2000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ukim448426@direct.novanthealth.org
Direct Messaging Address ukim448426@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20170818002307 NC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2365714730 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Practice addresses (Care Compare)

186 Kimel Park Dr
Winston Salem, NC 27103-6946
Phone (336) 277-2000

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 277-8800

Hospital & facility affiliations

  • Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014
  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017-01151NCMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Presbyterian Hospital CurrentSince Apr 13, 2023 Accepting new patients
The Presbyterian Hospital Current Accepting new patients
Novant Health Medical Group, LLC Cardiovascular Disease CurrentSince Feb 1, 2021 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Jul 24, 2018 Accepting new patients
Forsyth Memorial Hospital Inc Cardiovascular Disease CurrentSince Sep 1, 2017 Accepting new patients
Medical Park Hospital LLC CurrentSince Oct 15, 2019 Accepting new patients
The Presbyterian Hospital CurrentSince Apr 13, 2023 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Novant Health Medical Group, LLC Cardiovascular Disease CurrentSince Nov 15, 2017 Accepting new patients
Forsyth Memorial Hospital, Inc. Cardiovascular Disease CurrentSince Sep 1, 2017 Accepting new patients
Novant Health Mint Hill Medical Center, LLC CurrentSince Oct 1, 2018 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Nov 15, 2017 Accepting new patients
Novant Health Ballantyne Medical Center LLC CurrentSince Sep 9, 2023 Accepting new patients
Medical Park Hospital LLC CurrentSince Oct 15, 2019 Accepting new patients
Forsyth Memorial Hospital, Inc Past Accepting new patients

Locations

10905 Providence Rd W
Charlotte, NC 28277
Phone (980) 488-4000

125 Queens Rd
Charlotte, NC 28204
Phone (980) 302-6380

8201 Healthcare Loop
Charlotte, NC 28215
Phone (980) 302-1000

125 Baldwin Ave
Ste 200
Charlotte, NC 28204
Phone (704) 384-5043

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

7114 Village Medical Cir
Clemmons, NC 27012
Phone (336) 893-2440

100 Johnson Ridge Medical Park
Elkin, NC 28621
Phone (336) 245-2100

3515 W Market St
Ste 110
Greensboro, NC 27403
Phone (336) 299-0099

1226 Eastchester Dr
#100
High Point, NC 27265
Phone (336) 481-8540

13245 Reese Blvd W
Ste 100
Huntersville, NC 28078
Phone (704) 316-3142

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

1710 Kernersville Medical Pkwy
Ste 205
Kernersville, NC 27284
Phone (336) 983-4500

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

211 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-1191

725 Highland Oaks Dr
Ste 200
Winston Salem, NC 27103
Phone (336) 277-2620

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

185 Kimel Park Dr
Winston Salem, NC 27103
Phone (336) 277-2000

186 Kimel Park Dr
Winston Salem, NC 27103
Phone (336) 277-2000

1950 S Hawthorne Rd
Winston Salem, NC 27103
Phone (336) 718-0600

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

2025 Frontis Plaza Blvd
Ste 100
Winston Salem, NC 27103
Phone (336) 718-6199

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 6

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": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1447543632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-277-2000",
            "fax_number": "336-277-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7114 VILLAGE MEDICAL CIR",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128004",
            "telephone_number": "336-893-2440",
            "fax_number": "336-893-2470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "186 Kimel Park Dr",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271036946",
            "country_code": "US",
            "telephone_number": "336-277-2000",
            "fax_number": "336-277-2050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "UN JU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-19",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "2017-01151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ukim448426@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "186 Kimel Park Dr",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271036946",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ukim448426@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "7114 Village Medical Cir",
            "city": "Clemmons",
            "state": "NC",
            "country_code": "US",
            "postal_code": "270128004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clemmons, NC

Sources for this page

Verify at the official NPI Registry.