Individual provider Active NPI

Grace Seunghee Kim, LIC.AC.

  • Acupuncturist
  • Lexington, MA
National Provider Identifier
1548547797
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
250192 Issued in MA
Practice address
442 Marrett Rd Ste 6
Lexington, MA 02421-7749
Phone
(781) 861-0560
Fax
(781) 810-8799
NPI assigned
Nov 15, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 250192 MA Primary

Addresses

Primary practice location

442 Marrett Rd Ste 6
Lexington, MA 02421-7749

Mailing address

442 Marrett Rd Ste 6
Lexington, MA 02421-7749
Phone (781) 861-0560

Other names 1

  • Seunghee Paek Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
250192MAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Acupuncture and Oriental Medicine Acupuncturist PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1321315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1548547797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 MARRETT RD STE 6",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024217749",
            "telephone_number": "781-861-0560",
            "fax_number": "781-810-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 MARRETT RD STE 6",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024217749",
            "telephone_number": "781-861-0560",
            "fax_number": "781-810-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "GRACE",
        "middle_name": "SEUNGHEE",
        "credential": "LIC.AC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MA",
            "license": "250192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SEUNGHEE",
            "last_name": "PAEK",
            "credential": "LIC.AC.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lexington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.