NPIMap

Individual provider Active NPI

Michael Christopher Kim, DO

  • Internal Medicine Physician
  • Rowlett, TX
National Provider Identifier
1609496702
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
T9717 Issued in TX
Practice address
6800 Scenic Dr
Rowlett, TX 75088-4552
Phone
(972) 520-9199
Fax
(972) 520-8256
NPI assigned
Apr 20, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X
Internal Medicine Physician 207R00000X T9717 TX Primary

Addresses

Primary practice location

6800 Scenic Dr
Rowlett, TX 75088-4552

Mailing address

6800 Scenic Dr
Rowlett, TX 75088-4552
Phone (972) 520-9199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230808001752 TX Practitioner - Internal Medicine 7012330558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Western University of Health Sciences College of Dental Med, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

6800 Scenic Dr
Suite 1071
Rowlett, TX 75088-4552
Phone (972) 535-2946

Hospital & facility affiliations

  • Baylor Scott and White Medical Center Lake Pointe Hospital, Rowlett, TX, CCN 450742
  • Baylor Scott & White Medical Center Plano Hospital, Plano, TX, CCN 450890
  • Baylor Scott & White Emergency Hospital Hospital, Aubrey, TX, CCN 670062
  • Baylor Scott & White the Heart Hospital Plano Hospital, Plano, TX, CCN 670025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T9717TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Single Specialty CurrentSince Sep 11, 2023 Accepting new patients
Healthtexas Provider Network Single Specialty CurrentSince Sep 11, 2023 Accepting new patients
Healthtexas Provider Network Single Specialty Current Accepting new patients
Lake Pointe Operating Company, LLC Past Accepting new patients
Healthtexas Provider Network Single Specialty Past Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

6800 Scenic Dr
Ste 1071
Rowlett, TX 75088
Phone (972) 520-8000

Interoperability endpoints

  • Direct secure messaging: mkim1194474@direct.sw.org

Organizations & group practices 5

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.

Hospital & facility affiliations 8

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": "1587340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1609496702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 SCENIC DR",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750884552",
            "telephone_number": "972-520-9199",
            "fax_number": "972-520-8256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 SCENIC DR",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750884552",
            "telephone_number": "972-520-9199",
            "fax_number": "972-520-8256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MICHAEL",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-20",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T9717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rowlett, TX

Sources for this page

Verify at the official NPI Registry.