Jeong H. Kim, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD00036606 Issued in WA

Practice address

11812 N Creek Pkwy N Ste 202
Bothell, WA 98011

Phone

(425) 287-5500

Fax

(425) 287-6440

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Issaquah Obstetrics and Gynecology PLLC

  • Obstetrics & Gynecology Physician
  • Issaquah, WA
  • NPI 1073581807
  NPD (past)
• Molina Healthcare of Washington, Inc

  • Family Medicine Physician
  • Bothell, WA
  • NPI 1659897163

  Internal Medicine

  NPD (past)
• Overlake Medical Clinics LLC

  • Specialist
  • Bellevue, WA
  • NPI 1871745703
  NPD (past)
• Overlake Medical Clinics, LLC

  • Specialist
  • Bellevue, WA
  • NPI 1801828421
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1861591786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3814 222ND PL SE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980214220",
            "telephone_number": "425-922-7401",
            "fax_number": "425-899-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11812 N CREEK PKWY N STE 202",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "98011",
            "telephone_number": "425-287-5500",
            "fax_number": "425-287-6440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14048 Juanita Dr NE",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980349712",
            "country_code": "US",
            "telephone_number": "425-899-5300",
            "fax_number": "425-899-5304",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3900 Factoria Blvd SE Ste A",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980061234",
            "country_code": "US",
            "telephone_number": "425-903-3141",
            "fax_number": "425-903-3142",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8725 S Tacoma Way",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "WA",
            "postal_code": "984994544",
            "country_code": "US",
            "telephone_number": "253-535-5552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JEONG",
        "middle_name": "H.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD0036606",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "WA",
            "license": "MD00036606",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00036606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020945",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ami Kiker, RN
• Sky Kili
• David A Killen, D.D.S.,
• Destiny Kilmer, LMP
• Hyunmi Kim
• John T Kim
• Joy Kim
• Mi Hyeon Kim, RN,MN BSN
• Karin Elke Kimbrough, LMP
• King County Public Hospital District No 2

• Internal Medicine Physician in Bothell, WA
• Providers in Bothell, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; 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.