NPIMap

Individual provider Active NPI

Eun Ju Kim

  • Chiropractor
  • New York, NY
National Provider Identifier
1578071668
Registry record updated Mar 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
012916 Issued in NY
Practice address
5037 Broadway FL 2
New York, NY 10034-1131
Phone
(212) 933-4330
NPI assigned
Jan 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 012916 NY Primary

Addresses

Primary practice location

5037 Broadway FL 2
New York, NY 10034-1131

Mailing address

5037 Broadway FL 2
New York, NY 10034-1131

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
012916NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spinal Zone Chiropractic PC Chiropractor Current Accepting new patients
Queens Spine Chiropractic PC Chiropractor Current Accepting new patients
Ej Chiropractic, P.C. Chiropractor Current Accepting new patients
Go Chiropractic, P.C. Chiropractor Past Accepting new patients

Organizations & group practices 4

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": "1515628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1578071668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5037 BROADWAY FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5037 BROADWAY FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341131",
            "telephone_number": "212-933-4330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "EUN JU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-11",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "012916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; 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.