Active NPI
Jina Kim
- Chiropractor
- Philadelphia, PA
National Provider Identifier
1629478169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC010935
- Practice address
- 5675 Rising Sun Ave
Suite 14
Philadelphia, PA 19120-2100 - Phone
- (404) 483-0776
- NPI assigned
- Sep 3, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC010935 | PA | Primary |
Addresses
Primary practice location
5675 Rising Sun Ave
Suite 14
Philadelphia, PA 19120-2100
Mailing address
5675 Rising Sun Ave
Suite 14
Philadelphia, PA 19120-2100
Phone (404) 483-0776
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC010935 | PA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418774400000",
"number": "1629478169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5675 RISING SUN AVE",
"address_2": "SUITE 14",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191202100",
"telephone_number": "404-483-0776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5675 RISING SUN AVE",
"address_2": "SUITE 14",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191202100",
"telephone_number": "404-483-0776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-03",
"last_updated": "2014-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "PA",
"license": "DC010935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.