P John Kim, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME0045274 Issued in FL

Practice address

18635 NW US Highway 441
High Springs, FL 32643-8708

Phone

(386) 454-2724

Fax

(386) 454-2899

NPI assigned

Jul 28, 2005

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 2

Other names 1

• Dr. Pyoung John Kim Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• P John Kim MD

  • Family Medicine Physician
  • High Springs, FL
  • NPI 1134511462
  NPD (past) Authorized official

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487894400000",
    "number": "1669472098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18635 NW US HIGHWAY 441",
            "city": "HIGH SPRINGS",
            "state": "FL",
            "postal_code": "326438708",
            "telephone_number": "386-454-2724",
            "fax_number": "386-454-2899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18635 NW US HIGHWAY 441",
            "city": "HIGH SPRINGS",
            "state": "FL",
            "postal_code": "326438708",
            "telephone_number": "386-454-2724",
            "fax_number": "386-454-2899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "P JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2017-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0045274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044632700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080010562",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PYOUNG JOHN",
            "last_name": "KIM",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Andrea Colette Johnson, ARNP
• Kristie Johnson, MSN,ARNP,PMHNP-BC
• Colton Jones
• Jpa Management LLC
• Scott Kelly
• Virgilia Delcarmen Zabala Korus, RDN, LDN
• Ann Elizabeth Lane, ARNP
• Heather Hobbs Lee, PA-C
• Richard Light, LMT
• Lakesha Terrell Lingard, LMFT

• Family Medicine Physician in High Springs, FL
• Providers in High Springs, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.