Active NPI
Kim Y Yoo, DC
- Nutrition Chiropractor
- Melrose Park, PA
National Provider Identifier
1528023272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Chiropractor
- License
- 004765
- Practice address
- 1135 W Cheltenham Ave
#1
Melrose Park, PA 19027-3008 - Phone
- (215) 782-3135
- Fax
- (215) 782-3134
- NPI assigned
- Apr 18, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nutrition Chiropractor | 111NN1001X | 004765 | PA | Primary |
Addresses
Primary practice location
1135 W Cheltenham Ave
#1
Melrose Park, PA 19027-3008
Mailing address
1135 W Cheltenham Ave
#1
Melrose Park, PA 19027-3008
Phone (215) 782-3135
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01267589 | Medicaid | PA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004765 | PA | MD | Nutrition Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1528023272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1135 W CHELTENHAM AVE",
"address_2": "#1",
"city": "MELROSE PARK",
"state": "PA",
"postal_code": "190273008",
"telephone_number": "215-782-3135",
"fax_number": "215-782-3134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1135 W CHELTENHAM AVE",
"address_2": "#1",
"city": "MELROSE PARK",
"state": "PA",
"postal_code": "190273008",
"telephone_number": "215-782-3135",
"fax_number": "215-782-3134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOO",
"first_name": "KIM",
"middle_name": "Y",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111NN1001X",
"taxonomy_group": "",
"desc": "Chiropractor, Nutrition",
"state": "PA",
"license": "004765",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01267589",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Melrose Park, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.