Margaret Jordan Kim

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY.0006048 Issued in CO

Practice address

1115 Elkton Dr Ste 102
Colorado Springs, CO 80907-3597

Phone

(719) 357-6471

NPI assigned

Feb 17, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Molly Jordan Kim Other name

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Martinich Enterprises, LLCGroup PAC ID 9830590397, 3 clinicians

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.

• Martinich Enterprises, LLC

  • Clinical Psychologist
  • Colorado Springs, CO
  • NPI 1114488624
  Medicare reassignment Care Compare group NPD
• Colorado Springs Psychological Services

  • Clinical Psychologist
  • Colorado Springs, CO
  • NPI 1982074969
  Medicare reassignment NPD
• Colorado Springs Psychological Services

  • Clinical Psychologist
  • Denver, CO
  • NPI 1699373621
  NPD

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

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1760180939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19085 WHITE FAWN DR",
            "city": "MONUMENT",
            "state": "CO",
            "postal_code": "801328975",
            "telephone_number": "207-841-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 ELKTON DR STE 102",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073597",
            "telephone_number": "719-357-6471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MARGARET",
        "middle_name": "JORDAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0006048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "KIM",
            "middle_name": "JORDAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jae-Kwon Kim, PH.D.
• JK Kim
• John C Kim, MD
• Joseph Hyon-Bae Kim, M.D.
• Kyoung Kim
• Rena Kim, M.P.H., B.S.N., R.N.
• Robert Bada Kim, MD
• SE Cho Kim
• Sharon Minji Kim
• Simon Kim, MD

• Clinical Psychologist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.