Individual provider Active NPI

Inkyo Kim, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1821069717
Registry record updated Dec 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD050752L Issued in PA
Practice address
6705 Old York Rd
Philadelphia, PA 19126-2841
Phone
(215) 224-2000
Fax
(215) 224-8651
NPI assigned
Jan 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD050752L PA Primary

Addresses

Primary practice location

6705 Old York Rd
Philadelphia, PA 19126-2841

Mailing address

2506 N Broad St
Suite 202
Colmar, PA 18915-9439
Phone (215) 997-2101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD050752LPAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449792000000",
    "number": "1821069717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2506 N BROAD ST",
            "address_2": "SUITE 202",
            "city": "COLMAR",
            "state": "PA",
            "postal_code": "189159439",
            "telephone_number": "215-997-2101",
            "fax_number": "215-997-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6705 OLD YORK RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191262841",
            "telephone_number": "215-224-2000",
            "fax_number": "215-224-8651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "INKYO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2015-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD050752L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.