Kyung Han Kim, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305205254 Issued in VA

Practice address

4304 Evergreen LN Ste 102
Annandale, VA 22003-3216

Phone

(703) 256-7979

Fax

(703) 256-7770

NPI assigned

Apr 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

NR Physical Therapy LLCGroup PAC ID 3870869720, 2 clinicians

Nova Rehab CorpGroup PAC ID 5294873709, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Nova Rehab Corp

  • Physical Therapist
  • Annandale, VA
  • NPI 1114150919

  DC

  Medicare reassignment Care Compare group NPD Authorized official
• NR Physical Therapy LLC

  • Physical Therapist
  • Centreville, VA
  • NPI 1912421108

  DC

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1831210335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4304 EVERGREEN LN STE 102",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033216",
            "telephone_number": "703-256-7979",
            "fax_number": "703-256-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4304 EVERGREEN LN STE 102",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033216",
            "telephone_number": "703-256-7979",
            "fax_number": "703-256-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KYUNG",
        "middle_name": "HAN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305205254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jee Hye Kim, FNP-BC
• Jin W. Kim, D.C.
• John K. Kim, M.D.
• Jung Suk Kim, L.AC
• Kwangsung Kim
• Kyung Jin Kim
• Michael M. Kim, D.D.S.
• Misuk Agnes Kim, M.D.
• Peter D Kim, M.D.
• Sophia Kim

• Physical Therapist in Annandale, VA
• Providers in Annandale, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.