Individual provider Active NPI

Cassie Kim

  • Student in an Organized Health Care Education/Training Program
  • Tyler, TX
National Provider Identifier
1811780828
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
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

Updated by the provider on Jun 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251010001133 TX Order and Referring Only - PsychiatryPractitioner - Psychiatry 9133626526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: 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

Verify at the official NPI Registry.