Active NPI
Eunkuk Kim, M.D.
- Rehabilitation Practitioner
- Winston Salem, NC
National Provider Identifier
1861641599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- License
- 147419
- Practice address
- Beacon Hill Dr
Apt a
Winston Salem, NC 27106 - Phone
- (336) 997-6842
- NPI assigned
- Sep 18, 2008
- Last updated
- Sep 18, 2008
- Sex
- Male
- 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 Practitioner | 225400000X | 147419 | NC | Primary |
Addresses
Primary practice location
Beacon Hill Dr
Apt a
Winston Salem, NC 27106
Mailing address
Medical Center Blvd
3Rd Floor, Sticht Center
Winston-Salem, NC 27157
Phone (336) 997-6842
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A0037895000 | Other | NC | MEDICOST |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 147419 | NC | MD | Rehabilitation Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221696000000",
"number": "1861641599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MEDICAL CENTER BLVD",
"address_2": "3RD FLOOR, STICHT CENTER",
"city": "WINSTON-SALEM",
"state": "NC",
"postal_code": "27157",
"telephone_number": "336-997-6842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BEACON HILL DR",
"address_2": "APT A",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "27106",
"telephone_number": "336-997-6842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "EUNKUK",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-09-18",
"last_updated": "2008-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "NC",
"license": "147419",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICOST",
"identifier": "A0037895000",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.