Active NPI
John Shinwon Kim, LAC
- Acupuncturist
- New York, NY
National Provider Identifier
1780224766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 006661
- Practice address
- 80 Maiden LN RM 1007
New York, NY 10038-4764 - Phone
- (212) 386-7812
- NPI assigned
- Jan 8, 2020
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 006661 | NY | Primary |
Addresses
Primary practice location
80 Maiden LN RM 1007
New York, NY 10038-4764
Mailing address
26 Citation Dr
Freehold, NJ 07728-4661
Phone (908) 907-1282
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
| License | State | Type | Specialty |
|---|---|---|---|
| 006661 | NY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578441600000",
"number": "1780224766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 CITATION DR",
"city": "FREEHOLD",
"state": "NJ",
"postal_code": "077284661",
"telephone_number": "908-907-1282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 MAIDEN LN RM 1007",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100384764",
"telephone_number": "212-386-7812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JOHN",
"middle_name": "SHINWON",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-01-08",
"last_updated": "2020-01-08",
"certification_date": "2020-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "006661",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.