Active NPI
Cecelia Kim
- Surgery Physician
- Johnson City, TN
National Provider Identifier
1619555679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 351362
- Practice address
- 325 N State of Franklin Rd
Johnson City, TN 37604-6056 - Phone
- (423) 439-7201
- NPI assigned
- Mar 31, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 351362 | LA | Primary |
Addresses
Primary practice location
325 N State of Franklin Rd
Johnson City, TN 37604-6056
Mailing address
325 N State of Franklin Rd
Johnson City, TN 37604-6056
Phone (423) 439-7201
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786060800000",
"number": "1619555679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 N STATE OF FRANKLIN RD",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376046056",
"telephone_number": "423-439-7201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 N STATE OF FRANKLIN RD",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376046056",
"telephone_number": "423-439-7201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "CECELIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-31",
"last_updated": "2026-08-07",
"certification_date": "2026-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "LA",
"license": "351362",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.