S John Kim, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

25060-020 Issued in WI

Practice address

10555 W Parnell Ave
Hales Corners, WI 53130-2000

Phone

(414) 427-5200

Fax

(414) 427-5205

NPI assigned

Aug 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• H.S. Psychological Services SC

  • Community/Behavioral Health Agency
  • Mukwonago, WI
  • NPI 1316169931
  NPD (past)
• Manos, Smith & Associates

  • Psychologist
  • Waukesha, WI
  • NPI 1215156658
  NPD (past)
• Stress Management & Mental Health Clinics Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Allis, WI
  • NPI 1003928391
  NPD (past)
• Thousand Mile Journey LLC

  • Family Nurse Practitioner
  • Milwaukee, WI
  • NPI 1699159962
  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1760599807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10555 W PARNELL AVE",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531302000",
            "telephone_number": "414-427-5200",
            "fax_number": "414-427-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10555 W PARNELL AVE",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531302000",
            "telephone_number": "414-427-5200",
            "fax_number": "414-427-5205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "S",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "25060-020",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "23181",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30565800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Journey Together ABA
• Cheryl A. Kalupa
• David Reed Keeling, DMD
• Keith D. Clemence, DDS
• Talene Kelegian
• Emalie King, M.S. SLP
• Brianna N Kirnbauer, B.A PSYCHOLOGY
• Ashley Kite
• Mary Beth Lynn Koski
• S. Paul Kuwayama, MD

• Psychiatry Physician in Hales Corners, WI
• Providers in Hales Corners, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.