Active NPI
Dong Hyun Kim, PT, DPT
- Physical Therapist
- Fulton, MD
National Provider Identifier
1639855323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 29502
- Practice address
- 7625 Maple Lawn Blvd
Fulton, MD 20759-2565 - Phone
- (301) 497-3070
- NPI assigned
- Jun 26, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 29502 | MD | Primary |
Addresses
Primary practice location
7625 Maple Lawn Blvd
Fulton, MD 20759-2565
Mailing address
7625 Maple Lawn Blvd
Fulton, MD 20759-2565
Phone (301) 497-3070
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- University of Maryland School of Medicine, 2023
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
7625 Maple Lawn Blvd
Suite 140
Fulton, MD 20759-2565
Phone (301) 497-3070
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29502 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Synergy Therapy, LLC | Physical Therapist | Current | Accepting new patients |
Locations
7625 Maple Lawn Blvd
Ste 140
Fulton, MD 20759
Phone (301) 497-3070
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1639855323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7625 MAPLE LAWN BLVD",
"city": "FULTON",
"state": "MD",
"postal_code": "207592565",
"telephone_number": "301-497-3070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7625 MAPLE LAWN BLVD",
"city": "FULTON",
"state": "MD",
"postal_code": "207592565",
"telephone_number": "301-497-3070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "DONG HYUN",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-26",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "29502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fulton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.