NPIMap

Individual provider Active NPI

David E Kim, MD

  • Internal Medicine Physician
  • Cartersville, GA
National Provider Identifier
1508959750
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
043675 Issued in GA
Practice address
491 E Main St
Cartersville, GA 30121-3353
Phone
(770) 387-4512
Fax
(770) 334-3667
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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 043675 GA Primary

Addresses

Primary practice location

491 E Main St
Cartersville, GA 30121-3353

Mailing address

491 E Main St
Cartersville, GA 30121-3353
Phone (770) 387-4512

Other identifiers 1

IdentifierTypeStateIssuer
00795484AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20100803000757 GA Practitioner - Internal Medicine 9537175336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

491 E Main St
Cartersville, GA 30121-3353
Phone (770) 387-4512

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
043675GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Healthcaring Clinic of Georgia, LLC CurrentSince Mar 7, 2021 Accepting new patients
David E Kim MD PC Internal Medicine CurrentSince Oct 31, 2000 Accepting new patients
Cartersville Family Dentistry, PC Past Accepting new patients

Locations

179 Pine Grove Rd
Ste A
Cartersville, GA 30120
Phone (770) 387-0750

491 E Main St
Cartersville, GA 30121
Phone (678) 535-1170

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Transitions Hospice IncRome, GA, CCN 111641 Hospice Contracted Managing Employee Jan 29, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1508959750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "491 E MAIN ST",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301213353",
            "telephone_number": "770-387-4512",
            "fax_number": "770-387-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "491 E MAIN ST",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301213353",
            "telephone_number": "770-387-4512",
            "fax_number": "770-334-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DAVID",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "043675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00795484A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

Verify at the official NPI Registry.