Lydia Yu Kim, M.S., LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT6715 Issued in TX

Practice address

1904 Southern Oaks
Carrollton, TX 75007-5306

Phone

(580) 695-8794

NPI assigned

Jan 27, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Lydia Yu Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1453852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1801253497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 N WASHINGTON AVE STE 5000",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461792",
            "telephone_number": "580-695-8794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 SOUTHERN OAKS",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750075306",
            "telephone_number": "580-695-8794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "LYDIA",
        "middle_name": "YU",
        "name_prefix": "Mrs.",
        "credential": "M.S., LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-27",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT6715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYDIA",
            "last_name": "YU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eun Jung Kim
• Hye Sook Kim
• James Kim, PHARMD
• Julie J Kim
• Kelly Seojung Kim, DDS
• Rachel Nury Kim, DR
• Seon Yeong Kim
• Stephen Kim, LPC
• Tae Kim, DMD
• Elizabeth Wanjeri Kimani

• Athletic Trainer in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; 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.