Individual provider Active NPI

Bo-Kyung Kim, PA-C

  • Physician Assistant
  • Clayton, NC
National Provider Identifier
1831988609
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-15687 Issued in NC
Practice address
2076 Veterans Pkwy Ste 230
Clayton, NC 27520-5303
Phone
(919) 553-5711
Fax
(919) 553-5712
NPI assigned
May 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-15687 NC Primary

Addresses

Primary practice location

2076 Veterans Pkwy Ste 230
Clayton, NC 27520-5303

Mailing address

4705 University Dr BLDG 700
Durham, NC 27707-3489
Phone (919) 237-1337

Other practice location 1

4350 US 421 S
Lillington, NC 27546-6760
Phone (910) 893-1210

Other names 1

  • Danielle Kim Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251223000873 NC Practitioner - Physician Assistant 5294220620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avance Care PAGroup PAC ID 3577634476, 244 clinicians

Practice addresses (Care Compare)

2076 Veterans Pkwy
Suite 230
Clayton, NC 27520-5303
Phone (919) 553-5711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-15687NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Avance Care, PA CurrentSince Sep 20, 2025 Accepting new patients

Locations

2076 Veterans Pkwy
Ste 230
Clayton, NC 27520
Phone (919) 553-5711

4705 University Dr
Bldg 700
Durham, NC 27707
Phone (919) 237-1337

7510 Ramble Way
Ste 107
Raleigh, NC 27616
Phone (919) 277-8880

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1746489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1831988609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 UNIVERSITY DR BLDG 700",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073489",
            "telephone_number": "919-237-1337",
            "fax_number": "866-538-4716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2076 VETERANS PKWY STE 230",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275205303",
            "telephone_number": "919-553-5711",
            "fax_number": "919-553-5712"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4350 US 421 S",
            "address_purpose": "LOCATION",
            "city": "Lillington",
            "state": "NC",
            "postal_code": "275466760",
            "country_code": "US",
            "telephone_number": "910-893-1210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "BO-KYUNG",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-06",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-15687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "KIM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clayton, NC

Sources for this page

Verify at the official NPI Registry.