Active NPI
Kyung Kim, MD
- Pediatric Pulmonology Physician
- Blythewood, SC
National Provider Identifier
1750761995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Pulmonology Physician
- License
- 8712
- Practice address
- 251 Columbia Club Dr E
Blythewood, SC 29016-9479 - Phone
- (803) 754-7711
- NPI assigned
- Jun 3, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Pulmonology Physician | 2080P0214X | 8712 | SC | Primary |
Addresses
Primary practice location
251 Columbia Club Dr E
Blythewood, SC 29016-9479
Mailing address
251 Columbia Club Dr E
Blythewood, SC 29016-9479
Phone (803) 765-2500
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 |
|---|---|---|---|
| 8712 | SC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433289600000",
"number": "1750761995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "251 COLUMBIA CLUB DR E",
"city": "BLYTHEWOOD",
"state": "SC",
"postal_code": "290169479",
"telephone_number": "803-765-2500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "251 COLUMBIA CLUB DR E",
"city": "BLYTHEWOOD",
"state": "SC",
"postal_code": "290169479",
"telephone_number": "803-754-7711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "KYUNG",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-06-03",
"last_updated": "2015-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0214X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Pulmonology",
"state": "SC",
"license": "8712",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blythewood, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.