Active NPI
Surim Kim, DO
- Psychiatry Physician
- East Lansing, MI
National Provider Identifier
1508557604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 5151016317
- Practice address
- 965 Wilson Rd RM A233
East Lansing, MI 48824-6410 - Phone
- (517) 353-4362
- Fax
- (517) 432-0927
- NPI assigned
- May 18, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 5151016317 | MI | Primary |
Addresses
Primary practice location
965 Wilson Rd RM A233
East Lansing, MI 48824-6410
Mailing address
965 Wilson Rd RM A233
East Lansing, MI 48824-6410
Phone (517) 353-4362
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)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5151016317 | MI | MD | Psychiatry Physician |
Interoperability endpoints
- surim.kim.1@25394.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719273600000",
"number": "1508557604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "965 WILSON RD RM A233",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488246410",
"telephone_number": "517-353-4362",
"fax_number": "517-432-0927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "965 WILSON RD RM A233",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488246410",
"telephone_number": "517-353-4362",
"fax_number": "517-432-0927"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SURIM",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-18",
"last_updated": "2024-06-25",
"certification_date": "2024-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "5151016317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.