Organization Active NPI

Young Rhan Kim, M.D. Inc.

  • Internal Medicine Physician
  • Hilo, HI
National Provider Identifier
1548466196
Registry record updated Jul 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
YOUNG RHAN KIM, M.D. INC.
Practice address
868 Ululani St
Suite 109
Hilo, HI 96720-3913
Phone
(808) 935-3909
Fax
(808) 961-3995
NPI assigned
Jun 21, 2007
Last updated
Jul 5, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2013

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

Authorized official

Name
Young Rhan Kim, M.D.NPI 1336206960
Title
Owner
Phone
(808) 935-3909

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

868 Ululani St
Suite 109
Hilo, HI 96720-3913

Mailing address

868 Ululani St
Suite 109
Hilo, HI 96720-3913
Phone (808) 935-3909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070628000039 HI Part B Supplier - Clinic/Group Practice 9335248541 Receives reassigned benefits from 1 practitioner
Practice locations: Hilo, HI

National Provider Directory

National Provider Directory

Locations

868 Ululani St
Ste 109
Hilo, HI 96720
Phone (808) 935-3909

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372982400000",
    "number": "1548466196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "868 ULULANI ST",
            "address_2": "SUITE 109",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967203913",
            "telephone_number": "808-935-3909",
            "fax_number": "808-961-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "868 ULULANI ST",
            "address_2": "SUITE 109",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967203913",
            "telephone_number": "808-935-3909",
            "fax_number": "808-961-3995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG RHAN KIM, M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2013-07-05",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "YOUNG",
        "authorized_official_middle_name": "RHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-935-3909",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.