Rebecca Nonesupplied Kim, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

N2600 Issued in TX

Practice address

4100 Everett Dr Ste 400
Kyle, TX 78640-6147

Phone

(512) 295-1333

Fax

(512) 406-7327

NPI assigned

Jun 14, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Pediatric Medicine

Education

Texas Tech University Health Science Center School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Austin Regional Clinic PAGroup PAC ID 3072507789, 398 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rkim20142@arcmd.direct-ci.com

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.

• Austin Regional Clinic, PA

  • Family Medicine Physician
  • Austin, TX
  • NPI 1821157579

  Pediatrics

  Medicare reassignment Care Compare group NPD
• Ascension Seton

  • Family Medicine Physician
  • Luling, TX
  • NPI 1215118609
  Medicare reassignment NPD
• Travis County Emergency Physicians PA

  • Emergency Medicine Physician
  • Austin, TX
  • NPI 1962440933
  Medicare reassignment
• Ascension Seton

  • Medicare Defined Swing Bed Hospital Unit
  • Smithville, TX
  • NPI 1598590101
  NPD
• Austin Regional Clinic, PA

  • Durable Medical Equipment & Medical Supplies
  • Kyle, TX
  • NPI 1235746413
  NPD
• Ascension Seton

  • Rural Health Clinic/Center
  • Lockhart, TX
  • NPI 1235234576
  NPD (past)
• Seton Hospitalist Service

  • Internal Medicine Physician
  • Austin, TX
  • NPI 1013293679
  NPD (past)

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1467656033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 E HIGHWAY 290",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787231142",
            "telephone_number": "512-483-9596",
            "fax_number": "512-406-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 EVERETT DR STE 400",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786406147",
            "telephone_number": "512-295-1333",
            "fax_number": "512-406-7327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 S Colorado St",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Lockhart",
            "state": "TX",
            "postal_code": "786442700",
            "country_code": "US",
            "telephone_number": "512-398-2578",
            "fax_number": "512-398-3755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "REBECCA",
        "middle_name": "NONESUPPLIED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N2600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "350763403",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MYUTMB 3805159053-COMMERCIAL NUMBER",
            "identifier": "3805159053",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "350763402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Payton Ann Kent
• Keshavi Patel PLLC
• Kids Dental Works
• Kids Tooth Team Kyle, PLLC
• Leah Mae Kilchrist, ATC, LAT
• Azaria Sereniti Kinfu
• Kyra Lynne Klare
• Lauren Alexis Klaus
• Kole Pierre Knutson, PA-C
• Dean Alphonse Kocay, M.D.

• Pediatrics Physician in Kyle, TX
• Providers in Kyle, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.