Active NPI
Si Young Kim, M.D.
- Anesthesiology Physician
- Clinton TWP, MI
National Provider Identifier
1528115359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 4301041133
- Practice address
- 15855 19 Mile Rd
Clinton TWP, MI 48038-3504 - Phone
- (586) 263-2373
- NPI assigned
- Jan 4, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 4301041133 | MI | Primary |
Addresses
Primary practice location
15855 19 Mile Rd
Clinton TWP, MI 48038-3504
Mailing address
15855 19 Mile Rd
Clinton TWP, MI 48038-3504
Phone (586) 263-2373
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
- Credentials
- Doctor of Medicine
Interoperability endpoints
- skim63514@direct.hfhs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1528115359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15855 19 MILE RD",
"city": "CLINTON TWP",
"state": "MI",
"postal_code": "480383504",
"telephone_number": "586-263-2373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15855 19 MILE RD",
"city": "CLINTON TWP",
"state": "MI",
"postal_code": "480383504",
"telephone_number": "586-263-2373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SI YOUNG",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MI",
"license": "4301041133",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton TWP, MI
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.