Suk Ki Kim, M.D.

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

17728 Issued in KY

Practice address

3332 Villa PT
Ste 104
Owensboro, KY 42303-7818

Phone

(270) 684-5679

Fax

(270) 684-5753

NPI assigned

Jun 9, 2005

Last updated

Jan 29, 2013By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Enrolled in KY, IN2 enrollments

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 2

Specialty

Interventional Pain ManagementAlso: Anesthesiology

Education

Other, 1967

Medicare assignment

May accept Medicare assignment

Group practices

Pain Management Centers of America, PSCGroup PAC ID 2769727114, 25 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sukkim@pmcoap-in.direct.office.nextgen.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pain Management Centers of America, PSC

  • Interventional Pain Medicine Physician
  • Evansville, IN
  • NPI 1992271811

  KY

  Medicare reassignment Care Compare group NPD
• Tri-State Advanced Pain Management

  • Interventional Pain Medicine Physician
  • Madisonville, KY
  • NPI 1306108618
  NPD Authorized official
• Tri-State Advanced Pain Management PLLC

  • Interventional Pain Medicine Physician
  • Owensboro, KY
  • NPI 1922186378
  Authorized official Same address or phone
• Anesthesiology Medical Services PSC

  • Anesthesiology Physician
  • Owensboro, KY
  • NPI 1144253840
  NPD (past)
• Pain Management Centers of America, PSC

  • Interventional Pain Medicine Physician
  • Hopkinsville, KY
  • NPI 1326510181
  NPD (past)

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1477557270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3332 VILLA PT",
            "address_2": "STE 104",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423037818",
            "telephone_number": "270-684-5679",
            "fax_number": "270-684-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3332 VILLA PT",
            "address_2": "STE 104",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423037818",
            "telephone_number": "270-684-5679",
            "fax_number": "270-684-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SUK",
        "middle_name": "KI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "KY",
            "license": "17728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100001550A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64177280",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kentucky Orthopedic Rehabilitation LLC (KORT Owensboro)
• Kentucky Orthopedic Rehabilitation LLC (KORT Physical Therapy)
• Sheila Kessinger
• Keystone Therapy Services LLC
• Brittany Claire Kieffner, ATC
• Amanda King, BCBA
• Bradley S. King, MD
• Emily King, PHARM.D.
• Ruth E King, M.S.,CCC-SLP
• Kingdom Cove Ministries, LLC

• Interventional Pain Medicine Physician in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Interventional Pain Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; 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.