Active NPI
Ji Kim, L.AC
- Acupuncturist
- Nanuet, NY
National Provider Identifier
1457907487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 006208
- Practice address
- 196 Main St
Nanuet, NY 10954-3324 - Phone
- (845) 501-7878
- NPI assigned
- Aug 15, 2019
- Reactivated
- Sep 11, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 006208 | NY | Primary |
Addresses
Primary practice location
196 Main St
Nanuet, NY 10954-3324
Mailing address
196 Main St
Nanuet, NY 10954-3324
Phone (845) 501-7878
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
| License | State | Type | Specialty |
|---|---|---|---|
| 006208 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Myung K Kim Acupuncture PC | Acupuncturist | Current | Accepting new patients |
Locations
196 Main St
Nanuet, NY 10954
Phone (845) 501-7878
Organizations & group practices 1
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.
-
- Acupuncturist
- Nanuet, NY
- NPI 1376199786
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583280000000",
"number": "1457907487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "196 MAIN ST",
"city": "NANUET",
"state": "NY",
"postal_code": "109543324",
"telephone_number": "845-501-7878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "196 MAIN ST",
"city": "NANUET",
"state": "NY",
"postal_code": "109543324",
"telephone_number": "845-501-7878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JI",
"credential": "L.AC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-08-15",
"last_updated": "2020-03-04",
"certification_date": "2020-03-04",
"deactivation_date": "2019-08-16",
"reactivation_date": "2019-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "006208",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nanuet, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.