NPIMap

Individual provider Active NPI

Sophia Kang, MD

  • Psychiatry Physician
  • Des Moines, IA
National Provider Identifier
1598076929
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD-44475 Issued in IA
Practice address
1111 6TH Ave # W3
Des Moines, IA 50314-2610
Phone
(515) 643-8350
Fax
(515) 643-5824
NPI assigned
Jun 30, 2010
Last updated
Jun 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X MD-44475 IA
Psychiatry Physician 2084P0800X 47184 AZ
Psychiatry Physician 2084P0800X R71721 AZ
Psychiatry Physician 2084P0800X MD-44475 IA Primary

Addresses

Primary practice location

1111 6TH Ave # W3
Des Moines, IA 50314-2610

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-8350

Other identifiers 1

IdentifierTypeStateIssuer
800904MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180108000664 IA Practitioner - Psychiatry 9537307798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

1111 6TH Ave
Des Moines, IA 50314-2613
Phone (515) 643-2084

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47184AZMDPsychiatry Physician
R71721AZMDPsychiatry Physician
MD-44475IAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc. Psychiatry CurrentSince Jan 8, 2018 Accepting new patients
Mercy Clinics, Inc. Current Accepting new patients
Mercy Clinics, Inc. CurrentSince Jan 8, 2018 Accepting new patients

Locations

1111 6th Ave
Des Moines, IA 50314
Phone (515) 247-3121

1111 6th Ave
#W3
Des Moines, IA 50314

330 Laurel St
Ste 1200
Des Moines, IA 50314
Phone (515) 643-5454

405 SW 5th St
Ste E
Des Moines, IA 50309
Phone (515) 358-7259

Interoperability endpoints

  • Direct secure messaging: skang3948805@direct.trinity-health.org

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1598076929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-643-8350",
            "fax_number": "515-643-5824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 6TH AVE # W3",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142610",
            "telephone_number": "515-643-8350",
            "fax_number": "515-643-5824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "SOPHIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IA",
            "license": "MD-44475",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "47184",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "R71721",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "MD-44475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800904",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.