Individual provider Active NPI

Donald H Kim, M.D.

  • Internal Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1821035916
Registry record updated Sep 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
21721 Issued in OK
Practice address
2815 SW 119TH St.
Oklahoma City, OK 73170-2605
Phone
(405) 692-9977
Fax
(405) 691-6347
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 21721 OK Primary
Pain Medicine Physician 208VP0000X 21721 OK

Addresses

Primary practice location

2815 SW 119TH St.
Oklahoma City, OK 73170-2605

Mailing address

PO Box 891977
Oklahoma City, OK 73189-1977
Phone (405) 692-9977

Other identifiers 1

IdentifierTypeStateIssuer
P00262362OtherOKRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20041203000012 OK Practitioner - Internal MedicinePractitioner - Interventional Pain Management 5395701262

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Donald H Kim MD PC Internal Medicine CurrentSince Jul 1, 2006 Accepting new patients
Centennial Health, PC PastSince May 1, 1992 Accepting new patients
Summit Medical Center Past Accepting new patients
National Family Medical Associates, LLC Internal Medicine PastSince Feb 1, 2023 Accepting new patients
SSM Health Care of Oklahoma Inc Past Accepting new patients
SSM Health Care of Oklahoma, Inc Past Accepting new patients
Alpha Omega Dental Past Accepting new patients

Locations

2815 SW 119th St
Oklahoma City, OK 73170
Phone (405) 692-7333

2821 SW 119th St
Oklahoma City, OK 73170
Phone (405) 692-7333

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189382400000",
    "number": "1821035916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 891977",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731891977",
            "telephone_number": "405-692-9977",
            "fax_number": "405-691-6347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 SW 119TH ST.",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731702605",
            "telephone_number": "405-692-9977",
            "fax_number": "405-691-6347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DONALD",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2007-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "21721",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "OK",
            "license": "21721",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00262362",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.