Henry J Kim, M.D.

Primary specialty

Pediatric Clinical & Laboratory Immunology PhysicianTaxonomy code 2080I0007X

License

MD.30559 Issued in AL

Practice address

58 Roy Beall Drive
Luverne, AL 36049-7329

Phone

(334) 335-1212

Fax

(334) 335-1217

NPI assigned

Apr 3, 2006

Last updated

Apr 18, 2011By the provider in NPPES

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Crenshaw County Health Care Authority

  dba Crenshaw Community Hospital

  • Critical Access Hospital
  • Luverne, AL
  • NPI 1750480406
  NPD (past)

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303084800000",
    "number": "1871555326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL CIRCLE",
            "city": "LUVERNE",
            "state": "AL",
            "postal_code": "360497329",
            "telephone_number": "334-335-1212",
            "fax_number": "334-335-1217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 ROY BEALL DRIVE",
            "city": "LUVERNE",
            "state": "AL",
            "postal_code": "360497329",
            "telephone_number": "334-335-1212",
            "fax_number": "334-335-1217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HENRY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2011-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA02405700",
            "primary": false
        },
        {
            "code": "2080I0007X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Clinical & Laboratory Immunology",
            "state": "AL",
            "license": "MD.30559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0467103",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lesa Renee Johnson, CRNA
• Martty Jo Jones, CRNP
• Timothy Kemp, CRC,ADC
• Anna Leigh Kilcrease, FNP-C
• Clinton Taylor Kilcrease, MD
• Jane W. Lamb, O.D.
• Vicki Law
• Lilymaze Healthcare LLC.
• Luverne Health and Rehabilitation, LLC
• Luverne Health Clinic, P.a.

• Pediatrics Physician in Luverne, AL
• Providers in Luverne, AL by specialty
• Pediatrics Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2011; 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.