Devin Paul Kim, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

47721 Issued in AZ

Practice address

13395 N Marana Main St BLDG B
Marana, AZ 85653-7008

Phone

(520) 682-1091

Fax

(520) 682-4132

NPI assigned

Jul 9, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: devin.kim.1@32652.direct.athenahealth.com
• Direct secure messaging: devin.kim@1278.direct.myezyaccess.com

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.

• Marana Health Center, Inc

  dba MHC Healthcare

  • Federally Qualified Health Center (FQHC)
  • Marana, AZ
  • NPI 1447263405

  Family Medicine

  Medicare reassignment NPD
• Marana Health Center Inc

  dba MHC Healthcare Dental Office

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1396512034
  NPD
• Marana Health Center, Inc

  dba MHC Integrated Care Pharmacy

  • Clinic Pharmacy
  • Tucson, AZ
  • NPI 1073072450
  NPD (past)

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

{
    "created_epoch": "1247097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1629207725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856530188",
            "telephone_number": "520-682-4111",
            "fax_number": "520-616-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13395 N MARANA MAIN ST BLDG B",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856537008",
            "telephone_number": "520-682-1091",
            "fax_number": "520-682-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DEVIN",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-09",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "AZ",
            "license": "47721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "914619",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keon Jones
• Kristen Elizabeth Jordon, M.S., CCC-SLP
• Nita Kathleen Kees, M.S., CCC-SLP
• Chester Bitter Kener, DMD
• Ali R Khan, MD
• Shannon King
• Diana Kathleen Knipp, RN
• Tracey Lee Kruse, C.O.T.A.
• Rachel Lacy, SLPA
• Anna Margaret Laluzerne, MS, CF-SLP

• Child & Adolescent Psychiatry Physician in Marana, AZ
• Providers in Marana, AZ by specialty
• Child & Adolescent Psychiatry Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; 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.

Verify at the official NPI Registry.