Individual provider Active NPI

Jasmine T Kim, D.C.

  • Chiropractor
  • Clive, IA
National Provider Identifier
1558352328
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6312 Issued in IA
Practice address
12257 University Ave Ste 220
Clive, IA 50325-8276
Phone
(515) 273-5555
NPI assigned
Nov 2, 2005
Last updated
Mar 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6312 IA Primary

Addresses

Primary practice location

12257 University Ave Ste 220
Clive, IA 50325-8276

Mailing address

12257 University Ave Ste 220
Clive, IA 50325-8276
Phone (515) 273-5555

Other practice location 1

1300 50th St
Suite 202
West Des Moines, IA 50266-5499
Phone (515) 273-5555

Other identifiers 2

IdentifierTypeStateIssuer
21031OtherIAWELLMARK
0214254MedicaidIA

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Clive Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050614000754 IA Practitioner - Chiropractic 8628012341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12257 Univeristy Ave
Suite 220
Clive, IA 50325-8276
Phone (515) 273-5555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6312IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Jasmine Kim Inc Chiropractor CurrentSince Jul 1, 2007 Accepting new patients

Locations

12257 University Ave
Ste 220
Clive, IA 50325
Phone (515) 273-5555

5938 Ashworth Rd
West Des Moines, IA 50266
Phone (515) 225-4002

1300 50th St
Ste 202
West Des Moines, IA 50266
Phone (515) 222-1689

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1558352328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12257 UNIVERSITY AVE STE 220",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258276",
            "telephone_number": "515-273-5555",
            "fax_number": "515-864-0284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12257 UNIVERSITY AVE STE 220",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258276",
            "telephone_number": "515-273-5555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 50th St",
            "address_2": "Suite 202",
            "address_purpose": "LOCATION",
            "city": "West Des Moines",
            "state": "IA",
            "postal_code": "502665499",
            "country_code": "US",
            "telephone_number": "515-273-5555",
            "fax_number": "515-273-5556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JASMINE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "6312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "21031",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0214254",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Clive",
            "affiliation": "N",
            "endpointDescription": "physical location",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "none",
            "address_1": "12257 University Ave Ste 220",
            "city": "Clive",
            "state": "IA",
            "country_code": "US",
            "postal_code": "503258276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.