Individual provider Active NPI

Sooyeon Gim, DC

  • Chiropractor
  • Bayside, NY
National Provider Identifier
1669848750
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
70 012702 Issued in NY
Practice address
20019 46TH Ave
Bayside, NY 11361-3018
Phone
(347) 653-2497
NPI assigned
Aug 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 70 012702 NY Primary
Acupuncturist 171100000X 006634 NY

Addresses

Primary practice location

20019 46TH Ave
Bayside, NY 11361-3018

Mailing address

20019 46TH Ave
Bayside, NY 11361-3018
Phone (347) 653-2497

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
70 012702NYMDChiropractor
006634NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Green Apple Acupuncture PC Acupuncturist Current Accepting new patients
Soho Chiropractic PC Chiropractor CurrentSince Nov 24, 2024 Accepting new patients
Sense Physical Therapy PC PastSince Sep 12, 2017 Accepting new patients
Woo Physical Therapy PC PastSince Oct 1, 2022 Accepting new patients

Locations

33 W 46th St
Ste 801
New York, NY 10036
Phone (212) 302-2692

147 W 25th St
Fl 7
New York, NY 10001
Phone (212) 206-1603

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1669848750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20019 46TH AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613018",
            "telephone_number": "347-653-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20019 46TH AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613018",
            "telephone_number": "347-653-2497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIM",
        "first_name": "SOOYEON",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-12",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "70 012702",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "006634",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.