NPIMap

Individual provider Active NPI

Soon Kuyn Kim, M.D

  • Geriatric Psychiatry Physician
  • Southfield, MI
National Provider Identifier
1841315231
Registry record updated Nov 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
4301031832 Issued in MI
Practice address
29433 Southfield Rd
Suite 201
Southfield, MI 48076-2031
Phone
(248) 905-5091
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry Physician 2084P0805X 4301031832 MI Primary

Addresses

Primary practice location

29433 Southfield Rd
Suite 201
Southfield, MI 48076-2031

Mailing address

29433 Southfield Rd
Suite 201
Southfield, MI 48076-2031
Phone (248) 905-5091

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301031832MIMDGeriatric Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgetown Behavioral Health Institute, LLC Past Accepting new patients
Aurora Behavioral Healthcare - Monte Vista, LLC Past Accepting new patients

Organizations & group practices 7

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383264000000",
    "number": "1841315231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29433 SOUTHFIELD RD",
            "address_2": "SUITE 201",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762031",
            "telephone_number": "248-905-5091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29433 SOUTHFIELD RD",
            "address_2": "SUITE 201",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762031",
            "telephone_number": "248-905-5091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SOON",
        "middle_name": "KUYN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2013-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "MI",
            "license": "4301031832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; 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.