Active NPI
Tae Yong Kim, CHIROPRACTOR
- Chiropractor
- Renton, WA
National Provider Identifier
1821397746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH 60183187
- Practice address
- 819 South 3Rd Street
Renton, WA 98057 - Phone
- (425) 687-2707
- Fax
- (206) 309-9063
- NPI assigned
- Mar 17, 2011
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH 60183187 | WA | Primary |
Addresses
Primary practice location
819 South 3Rd Street
Renton, WA 98057
Mailing address
12505 Bel Red Rd
#112
Bellevue, WA 98005-2510
Phone (425) 484-9230
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH 60183187 | WA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Zephyr Chiropractic | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba South Lake Union Chiropractic and Massage
- Chiropractor
- Seattle, WA
- NPI 1891969200
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392681600000",
"number": "1821397746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12505 BEL RED RD",
"address_2": "#112",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980052510",
"telephone_number": "425-484-9230",
"fax_number": "206-309-9063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "819 SOUTH 3RD STREET",
"city": "RENTON",
"state": "WA",
"postal_code": "98057",
"telephone_number": "425-687-2707",
"fax_number": "206-309-9063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "TAE YONG",
"credential": "CHIROPRACTOR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-03-17",
"last_updated": "2014-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "CH 60183187",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.