Eli Yong Kim, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

50377 Issued in TN

Practice address

5545 Little Debbie Pkwy
Ooltewah, TN 37363-4357

Phone

(407) 451-6307

NPI assigned

Oct 8, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Dermatology

Education

Loma Linda University School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Es Health LLCGroup PAC ID 2668838061, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eli.kim@sccdc.gadirect.net
• Direct secure messaging: ekim@cleardermclinic.emadirect.md

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.

• Es Health LLC

  • Dermatology Physician
  • Ooltewah, TN
  • NPI 1740995968
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1254960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1861727802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5545 LITTLE DEBBIE PKWY",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373634357",
            "telephone_number": "407-451-6307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5545 LITTLE DEBBIE PKWY",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373634357",
            "telephone_number": "407-451-6307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ELI",
        "middle_name": "YONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-08",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "070656",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "50377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa G Kelley, PTA
• Darlene Kellogg, CNA
• Howard Michael Kennedy Jr., PA-C
• Janine Marie Kennedy, PA-C
• Kidney Center of Ooltewah- Collegedale LLC
• Amanda Kirkpatrick, RD, LDN
• Mark David Kirshner, C.PED, CO
• Klinner Enterprises
• Thomas Robert Klinner, MD
• Kenneth Knoechel, LPC

• Dermatology Physician in Ooltewah, TN
• Providers in Ooltewah, TN by specialty
• Dermatology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.