Soo Chan Kim

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305217403 Issued in VA

Practice address

11490 Commerce Park Dr Ste 412
Reston, VA 20191-1590

Phone

(703) 564-4636

NPI assigned

Aug 14, 2025

Last updated

Oct 8, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Fusion Physiotherapy Associates LLC

  • Physical Therapist
  • Fredericksburg, VA
  • NPI 1730530213

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1755129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1609752666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11490 COMMERCE PARK DR STE 412",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911590",
            "telephone_number": "703-860-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11490 COMMERCE PARK DR STE 412",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911590",
            "telephone_number": "703-564-4636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SOO CHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-14",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305217403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen Christina Kiel, L.C.S.W.
• Alice Kim, RPH
• Hannah Kim, AU.D., CCC-A
• Jeong I Kim
• Sonny Sunghun Kim
• Soojin Kim, MD
• Erin Helena Kimmelman, BCBA
• Daniel M Kimonyi
• Margaret King, O.G.N.P.
• Amy B Kirby, MD

• Physical Therapist in Reston, VA
• Providers in Reston, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; 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.