Individual provider Active NPI

Monica Amy Kim, D.C

  • Chiropractor
  • Oviedo, FL
National Provider Identifier
1619115490
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 9659 Issued in FL
Practice address
40 Alexandria Blvd Ste 1020
Oviedo, FL 32765-8910
Phone
(407) 359-0047
Fax
(407) 359-0071
NPI assigned
Feb 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 9659 FL Primary

Addresses

Primary practice location

40 Alexandria Blvd Ste 1020
Oviedo, FL 32765-8910

Mailing address

1451 Clayton Dr
Deltona, FL 32725-7457
Phone (850) 294-5280

Other practice location 1

3240 W Lake Mary Blvd
Suite 1300
Lake Mary, FL 32746-3583
Phone (407) 302-5161

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100923000907 FL Practitioner - Chiropractic 1951427236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

40 Alexandria Blvd
Suite 1020
Oviedo, FL 32765-8910
Phone (407) 359-0047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 9659FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Procare Chiropractic and Rehab LLC Chiropractor CurrentSince Jan 17, 2024 Accepting new patients

Locations

3240 W Lake Mary Blvd
Ste 1300
Lake Mary, FL 32746
Phone (407) 302-5161

40 Alexandria Blvd
Ste 1020
Oviedo, FL 32765
Phone (407) 359-0047

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1619115490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 CLAYTON DR",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327257457",
            "telephone_number": "850-294-5280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 ALEXANDRIA BLVD STE 1020",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327658910",
            "telephone_number": "407-359-0047",
            "fax_number": "407-359-0071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3240 W Lake Mary Blvd",
            "address_2": "Suite 1300",
            "address_purpose": "LOCATION",
            "city": "Lake Mary",
            "state": "FL",
            "postal_code": "327463583",
            "country_code": "US",
            "telephone_number": "407-302-5161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "MONICA",
        "middle_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-02",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 9659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.