Ed Kim, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT22700 Issued in CA

Legal business name

ED KIM, INC.

Doing business as

Kim Physical Therapy

Practice address

3838 Sherman Dr Ste 11
Riverside, CA 92503-4001

Phone

(951) 353-2831

Fax

(951) 353-2834

NPI assigned

Jul 13, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ed Kim, MPT

Title

President

Phone

(951) 353-2831

Specialties & licenses 1

Addresses

Other names 1

• Kim Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edward Kim, MPT

  • Orthopedic Physical Therapist
  • Riverside, CA
  • NPI 1356394613
  Medicare reassignment NPD

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811912629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 SHERMAN DR STE 11",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925034001",
            "telephone_number": "951-353-2831",
            "fax_number": "951-353-2834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 SHERMAN DR STE 11",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925034001",
            "telephone_number": "951-353-2831",
            "fax_number": "951-353-2834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ED KIM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "ED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-353-2831",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT22700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kim Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erika Echevarria
• Michelle Yap Echeverria, FNP-BC
• Crystal Lynn Echols, LVN
• Shawna Marlene Echols
• Crystal Alicia Eckhart
• Amanda Eddy
• Bartholomew A Edem-Enang, PHD STUDENT
• Jennie Lisette Edeza
• Edgar Ardila MD Inc.
• Jason Edgar, PSY.D.

• Physical Therapist in Riverside, CA
• Providers in Riverside, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.