Young Rock Kim, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

01026128A Issued in IN

Practice address

9815 Twin Creek Blvd
Munster, IN 46321-4122

Phone

(219) 924-2295

NPI assigned

Jun 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Illiana Surgery & Medical Center, LLC

  • Orthopaedic Surgery Physician
  • Merrillville, IN
  • NPI 1962401927
  NPD (past)

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1457556938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9815 TWIN CREEK BLVD",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463214122",
            "telephone_number": "219-924-2295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9815 TWIN CREEK BLVD",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463214122",
            "telephone_number": "219-924-2295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YOUNG",
        "middle_name": "ROCK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01026128A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN",
            "identifier": "01026128A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Khanna, MD
• J. Mark Killmer, LMFT
• Daniel D Kim, MD
• Hyeon Jin Kim
• Jean H Kim, M.D.
• Heidi A King, RD
• Mark T. Kinne, M.D.
• Nicole C Kiszka-Hazy, LMHC
• Jessica Kiszka, AGACNP-BC
• Kyle Kleist, D.O.

• Obstetrics & Gynecology Physician in Munster, IN
• Providers in Munster, IN by specialty
• Obstetrics & Gynecology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.