Organization Active NPI

Chong Kim PA

  • Otolaryngology/Facial Plastic Surgery Physician
  • Holmdel, NJ
National Provider Identifier
1518296359
Registry record updated Dec 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
25MA07219600 Issued in NJ
Legal business name
CHONG KIM PA
Practice address
100 Commons Way
Suite 701
Holmdel, NJ 07733-2934
Phone
(732) 796-0182
NPI assigned
Dec 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2009

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

Authorized official

Name
Dr. Chong S Kim, M.D.
Title
President
Phone
(732) 796-0182

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207YX0905X 25MA07219600 NJ Primary

Addresses

Primary practice location

100 Commons Way
Suite 701
Holmdel, NJ 07733-2934

Mailing address

100 Commons Way
Suite 701
Holmdel, NJ 07733-2934
Phone (732) 796-0182

National Provider Directory

National Provider Directory

Locations

100 Commons Way
Ste 701
Holmdel, NJ 07733
Phone (732) 335-8335

NPI Registry JSON

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

{
    "created_epoch": "1260144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260144000000",
    "number": "1518296359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 COMMONS WAY",
            "address_2": "SUITE 701",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077332934",
            "telephone_number": "732-796-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COMMONS WAY",
            "address_2": "SUITE 701",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077332934",
            "telephone_number": "732-796-0182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHONG KIM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-07",
        "last_updated": "2009-12-07",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "CHONG",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-796-0182",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "NJ",
            "license": "25MA07219600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.