Charles Brian Kim, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

14791 Issued in NV

Practice address

8930 W Sunset Rd
Suite #300
Las Vegas, NV 89148

Phone

(702) 258-7788

Fax

(702) 258-7787

NPI assigned

Aug 8, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Vegas Vascular Specialists PLLC

  • Vascular Surgery Physician
  • Las Vegas, NV
  • NPI 1700523917
  NPD
• Summerlin Hospital Medical Center L L C

  dba Summerlin Hospital Medical Center

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1831189638
  NPD (past)

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

{
    "created_epoch": "1218153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1457507527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9811 W CHARLESTON BLVD",
            "address_2": "#2640",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89117",
            "telephone_number": "702-258-7788",
            "fax_number": "702-258-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8930 W SUNSET RD",
            "address_2": "SUITE #300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89148",
            "telephone_number": "702-258-7788",
            "fax_number": "702-258-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHARLES",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-08",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "K50014282195",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NV",
            "license": "14791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Kim
• Ashley Yenny Kim, FNP-BC
• Bo-Young Kim
• Byonghun Kim
• Caren Kim, MS, CCC-SLP
• Christine Hae Yon Kim
• Chu Hyun Kim
• Cindy Kim, DMD
• Cristina L Kim, DNP, PNP
• Daniel Kim

• Surgery Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Surgery Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.