Individual provider Active NPI

Joseph Hyon-Bae Kim, M.D.

  • Internal Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1477557890
Registry record updated Oct 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
32551 Issued in CO
Practice address
175 S Union Blvd
Ste 350
Colorado Springs, CO 80910-3146
Phone
(719) 633-5515
Fax
(719) 471-2258
NPI assigned
Jun 13, 2005
Last updated
Oct 8, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 32551 CO Primary

Addresses

Primary practice location

175 S Union Blvd
Ste 350
Colorado Springs, CO 80910-3146

Mailing address

175 S Union Blvd
Suite 350
Colorado Springs, CO 80910-3113
Phone (719) 633-5515

Other identifiers 1

IdentifierTypeStateIssuer
01325513MedicaidCO

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32551COMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254960000000",
    "number": "1477557890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 S UNION BLVD",
            "address_2": "SUITE 350",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103113",
            "telephone_number": "719-633-5515",
            "fax_number": "719-471-2258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 S UNION BLVD",
            "address_2": "STE 350",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103146",
            "telephone_number": "719-633-5515",
            "fax_number": "719-471-2258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOSEPH",
        "middle_name": "HYON-BAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2009-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "32551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01325513",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2009; 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.