Active NPI
Il Gon Kim, M.D.
- Specialist
- Hughesville, PA
National Provider Identifier
1649519760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MD-028191-L
- Practice address
- 4060 Route 220 Hwy
Hughesville, PA 17737-8916 - Phone
- (570) 584-4134
- NPI assigned
- Feb 8, 2013
- Last updated
- Feb 8, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | MD-028191-L | PA | Primary |
Addresses
Primary practice location
4060 Route 220 Hwy
Hughesville, PA 17737-8916
Mailing address
420 S Main St
Hughesville, PA 17737-1630
Phone (570) 584-4134
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-028191-L | PA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360281600000",
"number": "1649519760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 S MAIN ST",
"city": "HUGHESVILLE",
"state": "PA",
"postal_code": "177371630",
"telephone_number": "570-584-4134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4060 ROUTE 220 HWY",
"city": "HUGHESVILLE",
"state": "PA",
"postal_code": "177378916",
"telephone_number": "570-584-4134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "IL",
"middle_name": "GON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-02-08",
"last_updated": "2013-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "PA",
"license": "MD-028191-L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hughesville, PA
- Hughesville Chiropractic P.C.
- Hughesville Volunteer Fire Department
- Thomas S Janca, MSPT
- Laurie A Jenkins, P.A.
- Corinne Leigh Jones, MSW, LCSW
- Quinn Kirk, MD
- Sarah A Knight, LCSW
- Lycoming County Montgomery's Pharmacy
- Lycoming County Montgomerys (Montgomerys Pharmacy)
- Morgan Terry Manchester-Ritchie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.