Individual provider Active NPI

Jin-Young Kim, D.C.

  • Chiropractor
  • Seattle, WA
National Provider Identifier
1699864728
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034110 Issued in WA
Practice address
1032 S Jackson St Ste 200
Seattle, WA 98104-3038
Phone
(206) 650-6524
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00034110 WA Primary

Addresses

Primary practice location

1032 S Jackson St Ste 200
Seattle, WA 98104-3038

Mailing address

14608 Highway 99 Ste 309
Lynnwood, WA 98087-5500
Phone (206) 650-6524

Other identifiers 1

IdentifierTypeStateIssuer
8393738MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040217000968 WA Practitioner - Chiropractic 2264327493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14608 Hwy 99 309
Lynnwood, WA 98087-5500
Phone (425) 742-0332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Atlas Chiropractic Clinic, LLC Chiropractor CurrentSince Apr 1, 2007 Accepting new patients

Locations

14608 Highway 99
Ste 309
Lynnwood, WA 98087
Phone (425) 742-0332

Organizations & group practices 1

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699864728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14608 HIGHWAY 99 STE 309",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980875500",
            "telephone_number": "206-650-6524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 S JACKSON ST STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043038",
            "telephone_number": "206-650-6524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JIN-YOUNG",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8393738",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.