NPIMap

Individual provider Active NPI

Paul E Kim, MD

  • Cardiovascular Disease Physician
  • Greenwood, SC
National Provider Identifier
1790777332
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
SC23182 Issued in SC
Practice address
421 Epting Ave
Greenwood, SC 29646-4041
Phone
(864) 227-6818
Fax
(864) 227-0850
NPI assigned
Aug 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X SC23182 SC Primary

Addresses

Primary practice location

421 Epting Ave
Greenwood, SC 29646-4041

Mailing address

421 Epting Ave
Greenwood, SC 29646-4041
Phone (864) 227-6818

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pkim127082@selfregional.direct-ci.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110225000702 SC Practitioner - Cardiovascular Disease (Cardiology) 6507047339 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Baylor College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Self Medical GroupGroup PAC ID 6002953916, 393 clinicians
Self Regional HealthcareGroup PAC ID 4082527742, 159 clinicians

Practice addresses (Care Compare)

105 Vinecrest CT
Greenwood, SC 29646-8031

1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4111

160 Academy Ave
Greenwood, SC 29646-3808
Phone (864) 223-8090

421 Epting Ave
Greenwood, SC 29646-4041
Phone (864) 227-6818

Hospital & facility affiliations

  • Self Regional Healthcare Hospital, Greenwood, SC, CCN 420071
  • Prisma Health Laurens County Hospital Hospital, Clinton, SC, CCN 420038
  • Abbeville Area Medical Center Hospital, Abbeville, SC, CCN 421301
  • Edgefield County Healthcare an Affiliate of Self R Hospital, Edgefield, SC, CCN 421304

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
SC23182SCMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Self Medical Group CurrentSince Apr 1, 2016 Accepting new patients
Self Regional Healthcare Cardiovascular Disease CurrentSince Dec 7, 2025 Accepting new patients
Abbeville County Memorial Hospital CurrentSince Apr 28, 2024 Accepting new patients
Self Medical Group Current Accepting new patients
Abbeville County Memorial Hospital CurrentSince Apr 28, 2024 Accepting new patients
Self Medical Group CurrentSince Apr 1, 2016 Accepting new patients
Self Medical Group PastSince May 7, 2024 Accepting new patients
Self Regional Healthcare Past Accepting new patients
Self Regional Healthcare Past Accepting new patients

Locations

75 Remittance Dr
Dept 6875
Chicago, IL 60675

75 Remittance Dr
Dept 6793
Chicago, IL 60675

75 Remittance Dr
Dept 6764
Chicago, IL 60675

905 W Greenwood St
Abbeville, SC 29620
Phone (864) 223-8090

420 Thomson Cir
Abbeville, SC 29620
Phone (864) 366-1649

23013 Highway 76 E
#A
Clinton, SC 29325
Phone (864) 223-8090

421 Epting Ave
Greenwood, SC 29646
Phone (864) 227-6818

1325 Spring St
Greenwood, SC 29646
Phone (864) 227-4111

155 Academy Ave
Greenwood, SC 29646
Phone (864) 725-4865

207 Holiday Rd
Mc Cormick, SC 29835
Phone (800) 922-4194

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

Organizations & group practices 10

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1790777332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 EPTING AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296464041",
            "telephone_number": "864-227-6818",
            "fax_number": "864-227-0850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 EPTING AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296464041",
            "telephone_number": "864-227-6818",
            "fax_number": "864-227-0850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "PAUL",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SC",
            "license": "SC23182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pkim127082@selfregional.direct-ci.net",
            "affiliation": "N",
            "address_1": "421 Epting Ave",
            "city": "Greenwood",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296464041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.