Active NPI
Sung Yong Kim, M.D
- Specialist
- Portsmouth, VA
National Provider Identifier
1790753762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 0101022964
- Practice address
- 3409 South St
Portsmouth, VA 23707-3219 - Phone
- (757) 399-0705
- Fax
- (757) 399-3978
- NPI assigned
- Mar 8, 2006
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 0101022964 | VA | Primary |
Addresses
Primary practice location
3409 South St
Portsmouth, VA 23707-3219
Mailing address
3409 South St
Portsmouth, VA 23707-3219
Phone (757) 399-0705
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6745075 | Medicaid | VA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1790753762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3409 SOUTH ST",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237073219",
"telephone_number": "757-399-0705",
"fax_number": "757-399-3978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3409 SOUTH ST",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237073219",
"telephone_number": "757-399-0705",
"fax_number": "757-399-3978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SUNG",
"middle_name": "YONG",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-08",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "VA",
"license": "0101022964",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6745075",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portsmouth, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.