Individual provider Active NPI

Min Kim

  • Physical Therapist
  • Greenfield, WI
National Provider Identifier
1760837710
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12341-24 Issued in WI
Practice address
4131 W Loomis Rd
Suit 200
Greenfield, WI 53221-2057
Phone
(414) 281-5151
NPI assigned
Apr 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 12341-24 WI Primary

Addresses

Primary practice location

4131 W Loomis Rd
Suit 200
Greenfield, WI 53221-2057

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other identifiers 1

IdentifierTypeStateIssuer
100055393MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address mkim87890@direct.myadvocateaurora.org Direct

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

State licenses

LicenseStateTypeSpecialty
12341-24WIMDPhysical Therapist

Interoperability endpoints

  • Direct secure messaging: mkim87890@direct.myadvocateaurora.org

NPI Registry JSON

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1760837710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 W LOOMIS RD",
            "address_2": "SUIT 200",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212057",
            "telephone_number": "414-281-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-27",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "12341-24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100055393",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4131 W Loomis Rd",
            "address_2": "suit 200",
            "city": "Greenfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532212057",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkim87890@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4131 W Loomis Rd",
            "address_2": "suit 200",
            "city": "Greenfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532212057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; 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.