Grace Kim, D.P.T

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

034507 Issued in NY

Practice address

873 Broadway
510
New York, NY 10003-1231

Phone

(212) 253-9383

NPI assigned

Jun 18, 2015

Last updated

Dec 21, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Grace Chang Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1841671567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 GRAND AVE",
            "address_2": "STE 516",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076501083",
            "telephone_number": "201-313-0313",
            "fax_number": "201-313-0806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "873 BROADWAY",
            "address_2": "510",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100031231",
            "telephone_number": "212-253-9383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "GRACE",
        "credential": "D.P.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-18",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "034507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "CHANG",
            "credential": "D.P.T",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gloria Kim
• Grace Kim, LCSW
• Grace Kim
• Grace Kim, D.D.S.
• Grace Kim
• Grace Kim
• Grace J. Kim, OTR
• Grace Juyoung Kim, MD
• Grace S Kim, NP
• Grace Yoon-Jeong Kim

• Physical Therapist in New York, NY
• Providers in New York, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; 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.