Active NPI
Cassie Kim
- Student in an Organized Health Care Education/Training Program
- Tyler, TX
National Provider Identifier
1811780828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- University of Texas Health Science Center at Tyler
11937 U.S. Hwy. 271
Tyler, TX 75708 - Phone
- (903) 877-7200
- NPI assigned
- May 23, 2025
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
University of Texas Health Science Center at Tyler
11937 U.S. Hwy. 271
Tyler, TX 75708
Mailing address
University of Texas Health Science Center at Tyler
11937 U.S. Hwy. 271
Tyler, TX 75708
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251010001133 | TX | Order and Referring Only - Psychiatry | 9133626526 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- ckim1349252@ahs.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748995200000",
"number": "1811780828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER",
"address_2": "11937 U.S. HWY. 271",
"city": "TYLER",
"state": "TX",
"postal_code": "75708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER",
"address_2": "11937 U.S. HWY. 271",
"city": "TYLER",
"state": "TX",
"postal_code": "75708",
"telephone_number": "903-877-7200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "CASSIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-23",
"last_updated": "2025-06-04",
"certification_date": "2025-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.