NPIMap

Individual provider Active NPI

George Gi-Min Kim, M.D.

  • Internal Medicine Physician
  • Tryon, NC
National Provider Identifier
1508906132
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9700614 Issued in NC
Practice address
2536 Lynn Rd
Suite B
Tryon, NC 28782-7875
Phone
(828) 859-7659
Fax
(828) 859-2470
NPI assigned
Feb 6, 2007
Last updated
Apr 22, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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 9700614 NC Primary

Addresses

Primary practice location

2536 Lynn Rd
Suite B
Tryon, NC 28782-7875

Mailing address

PO Box 219
Lynn, NC 28750-0219
Phone (828) 859-7659

Other identifiers 4

IdentifierTypeStateIssuer
891061YMedicaidNC
P00243621OtherNCRAILROAD MEDICARE
1061YOtherNCBLUE CROSS BLUE SHIELD
N0061DMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041215000178 NC Practitioner - Internal Medicine 2062479025 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loma Linda University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11 Sunshine LN
Columbus, NC 28722-0237
Phone (828) 859-7659

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St. Lukes Hospital Inc. CurrentSince Aug 1, 2007 Accepting new patients
St. Luke's Hospital Inc. CurrentSince Aug 1, 2007 Accepting new patients

Locations

101 Hospital Dr
Columbus, NC 28722
Phone (828) 894-3311

Interoperability endpoints

  • Direct secure messaging: george.kim.1@23197.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/23197/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1508906132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 219",
            "city": "LYNN",
            "state": "NC",
            "postal_code": "287500219",
            "telephone_number": "828-859-7659",
            "fax_number": "828-859-2470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2536 LYNN RD",
            "address_2": "SUITE B",
            "city": "TRYON",
            "state": "NC",
            "postal_code": "287827875",
            "telephone_number": "828-859-7659",
            "fax_number": "828-859-2470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "GEORGE",
        "middle_name": "GI-MIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9700614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891061Y",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00243621",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1061Y",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N0061D",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tryon, NC

Sources for this page

Verify at the official NPI Registry.