Peter K Kim, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DS038506 Issued in PA

Practice address

413 W Germantown Pike
Norristown, PA 19403-4229

Phone

(201) 315-9217

NPI assigned

Feb 9, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: pkim19645@choctawnation.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.

• Choctaw Nation of Oklahoma

  • Primary Care Clinic/Center
  • Broken Bow, OK
  • NPI 1770559619
  NPD (past)

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

{
    "created_epoch": "1297209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1497051379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 W GERMANTOWN PIKE",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194034229",
            "telephone_number": "201-315-9217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 W GERMANTOWN PIKE",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194034229",
            "telephone_number": "201-315-9217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "PETER",
        "middle_name": "K",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-09",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02452300",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS038506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ebony Kilson, LBS
• Amanda Kim
• CHI Kim
• Christine Kim
• Jessica Kim
• Sylvia Kim
• Vanessa Kim
• Jeremy L. King, DO
• Jummy Mary-Janet Kirby
• Larry Erwin Klein, RPH

• Dentist in Norristown, PA
• Providers in Norristown, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.