Kevin Hyungsup Kim, DC, LAC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104556491 Issued in VA

Practice address

10195 Main St Ste F
Fairfax, VA 22031-3415

Phone

(703) 277-9897

Fax

(703) 277-9535

NPI assigned

Sep 25, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Golden Chiro Acupuncture Clinic LLC

  • Rehabilitation Chiropractor
  • Fairfax, VA
  • NPI 1932585163

  Acupuncturist, DC

  Medicare reassignment NPD Authorized official
• Golden Chiro Acupuncture Clinic LLC

  • Acupuncturist
  • Fairfax, VA
  • NPI 1730549346
  NPD (past) Authorized official

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432684800000",
    "number": "1679723720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10195 MAIN ST STE F",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220313415",
            "telephone_number": "703-277-9897",
            "fax_number": "703-277-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10195 MAIN ST STE F",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220313415",
            "telephone_number": "703-277-9897",
            "fax_number": "703-277-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KEVIN",
        "middle_name": "HYUNGSUP",
        "name_prefix": "Dr.",
        "credential": "DC, LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-25",
        "last_updated": "2015-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC30297",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556491",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "VA",
            "license": "0121000759",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerry Chongmin Kim, DDS
• Jinwook Kim, L.AC.
• Jonathan Kim, OD
• Joseph Jihoon Kim, MA.,CCC-SLP
• Kenneth Jae Yoon Kim, MD
• Mi Yong Kim, MD
• Michael Kim
• Michael Donhyun Kim, MD
• Mina Kim, PHARM.D
• Mina Kim

• Chiropractor in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; 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.

Verify at the official NPI Registry.