NPIMap

Organization Active NPI

Kim Orthopedic LLC

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Jacksonville, FL
National Provider Identifier
1467071829
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
Legal business name
KIM ORTHOPEDIC LLC
Practice address
2 Shircliff Way Ste 605
Jacksonville, FL 32204-4762
Phone
(904) 328-5979
Fax
(904) 619-9925
NPI assigned
Apr 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

Authorized official

Name
Eric G Kim, DONPI 1124463088
Title
Owner
Phone
(904) 868-5716

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XS0114X Primary

Addresses

Primary practice location

2 Shircliff Way Ste 605
Jacksonville, FL 32204-4762

Mailing address

2 Shircliff Way Ste 605
Jacksonville, FL 32204-4762
Phone (904) 328-5979

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL drheekin@direct.heekinclinic.nextshare.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590537600000",
    "number": "1467071829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SHIRCLIFF WAY STE 605",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044762",
            "telephone_number": "904-328-5979",
            "fax_number": "904-619-9925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SHIRCLIFF WAY STE 605",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044762",
            "telephone_number": "904-328-5979",
            "fax_number": "904-619-9925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM ORTHOPEDIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-15",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-868-5716",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "drheekin@direct.heekinclinic.nextshare.com",
            "affiliation": "N",
            "endpointDescription": "Nextgen EHR system",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2 Shircliff Way Ste 605",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322044762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.

Verify at the official NPI Registry.