Individual provider Active NPI

Karin Kim, DC

  • Chiropractor
  • Long Beach, CA
National Provider Identifier
1871777417
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC26753 Issued in CA
Practice address
1225 E Wardlow Rd
Long Beach, CA 90807
Phone
(562) 997-0966
Fax
(562) 981-6637
NPI assigned
Dec 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC26753 CA Primary

Addresses

Primary practice location

1225 E Wardlow Rd
Long Beach, CA 90807

Mailing address

3620 Long Beach Blvd
C-11
Long Beach, CA 90807-4022
Phone (562) 997-0966

Other identifiers 1

IdentifierTypeStateIssuer
510514037OtherCATAX IDENTIFICATION NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120209000350 CA Practitioner - Chiropractic 6406013077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Groves Chiropractic, IncGroup PAC ID 7517124118, 2 clinicians

Practice addresses (Care Compare)

1225 E Wardlow Rd
Long Beach, CA 90807-4832
Phone (562) 997-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC26753CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Groves Chiropractic, Inc Chiropractor CurrentSince Jun 23, 2004 Accepting new patients

Locations

3620 Long Beach Blvd
Ste C11
Long Beach, CA 90807
Phone (562) 997-0966

1225 E Wardlow Rd
Long Beach, CA 90807
Phone (562) 997-0966

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1871777417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 LONG BEACH BLVD",
            "address_2": "C-11",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908074022",
            "telephone_number": "562-997-0966",
            "fax_number": "562-981-6637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 E WARDLOW RD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90807",
            "telephone_number": "562-997-0966",
            "fax_number": "562-981-6637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KARIN",
        "name_prefix": "Mrs.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-18",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC26753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "510514037",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.