Active NPI
Kyung Sik Kim, MD
- Family Medicine Physician
- Silver Spring, MD
National Provider Identifier
1821011982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- D27618
- Practice address
- 206 Shaw Ave
Silver Spring, MD 20904-3527 - Phone
- (301) 622-5883
- Fax
- (301) 622-7095
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | D27618 | MD | Primary |
Addresses
Primary practice location
206 Shaw Ave
Silver Spring, MD 20904-3527
Mailing address
206 Shaw Ave
Silver Spring, MD 20904-3527
Phone (301) 622-5883
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120215000038 | DC | Practitioner - Family Practice | 6406014836 | Practice locations: Silver Spring, MD |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D27618 | MD | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821011982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 SHAW AVE",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209043527",
"telephone_number": "301-622-5883",
"fax_number": "301-622-7095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 SHAW AVE",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209043527",
"telephone_number": "301-622-5883",
"fax_number": "301-622-7095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "KYUNG",
"middle_name": "SIK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MD",
"license": "D27618",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Silver Spring, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.