Soon Kim, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

10696 Issued in NV

Practice address

1516 Virginia Ranch Rd
Gardnerville, NV 89410-5794

Phone

(775) 783-3020

Fax

(775) 783-3021

NPI assigned

Aug 31, 2006

Last updated

Jan 21, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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 NV

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

Specialty

General Surgery

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mesquite Clinic Management Company LLCGroup PAC ID 8123456456, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mesa View Regional Hospital Hospital, Mesquite, NV, CCN 291307

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: skim029@yourcarecommunity.org
• Direct secure messaging: soon.kim.2@2184.direct.athenahealth.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.

• Mesquite Clinic Management Company LLC

  • Internal Medicine Physician
  • Mesquite, NV
  • NPI 1548800501
  Medicare reassignment Care Compare group NPD
• Mesquite Clinic Management Company LLC

  • Rural Health Clinic/Center
  • Logandale, NV
  • NPI 1982275236
  NPD
• MMC of Nevada LLC

  dba Mesa View Regional Hospital

  • Critical Access Hospital
  • Mesquite, NV
  • NPI 1275588782
  NPD (past)
• Washoe Barton Medical Clinic a Nevada Nonprofit Corporation

  dba Carson Valley Health

  • Critical Access Hospital
  • Gardnerville, NV
  • NPI 1396799102
  NPD (past)
• Covenant Hospital Hobbs

  dba Covenant Health Hobbs Hospital

  • General Acute Care Hospital
  • Hobbs, NM
  • NPI 1215534466
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• MMC of Nevada LLC

  dba Mesa View Regional Hospital

  • Critical Access Hospital
  • Mesquite, NV
  • NPI 1275588782
  Care Compare affiliation

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358726400000",
    "number": "1649381153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 VIRGINIA RANCH RD",
            "city": "GARDNERVILLE",
            "state": "NV",
            "postal_code": "894105794",
            "telephone_number": "775-783-3020",
            "fax_number": "775-783-3021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 VIRGINIA RANCH RD",
            "city": "GARDNERVILLE",
            "state": "NV",
            "postal_code": "894105794",
            "telephone_number": "775-783-3020",
            "fax_number": "775-783-3021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SOON",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2013-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NV",
            "license": "10696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100502384",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandi Keenan
• Melanie Keffer, M.S., CCC-SLP
• James V. Kiernan, LCSW,LADC
• Tarasita Kilmartin, NP
• Ashley Kim
• Jacqueline Kizer
• Lyndsey Kramm, FNP-BC
• Lake Tahoe Orthopaedic Institute
• Lakeside Medical
• Mary Pierce Lamore, PT

• Surgery Physician in Gardnerville, NV
• Providers in Gardnerville, NV by specialty
• Surgery Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2013; 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.
• 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.