Active NPI
Candis Kim
- Rehabilitation Counselor
- Champaign, IL
National Provider Identifier
1831409432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Counselor
- Practice address
- 3310 Sharp Dr.
Champaign, IL 61822 - Phone
- (217) 390-6554
- NPI assigned
- Oct 15, 2010
- Last updated
- Oct 15, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Rehabilitation Counselor | 225C00000X | NU | Primary |
Addresses
Primary practice location
3310 Sharp Dr.
Champaign, IL 61822
Mailing address
3310 Sharp Dr.
Champaign, IL 61822
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287100800000",
"number": "1831409432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3310 SHARP DR.",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "61822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3310 SHARP DR.",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "61822",
"telephone_number": "217-390-6554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "CANDIS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-15",
"last_updated": "2010-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "225C00000X",
"taxonomy_group": "",
"desc": "Rehabilitation Counselor",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.