Active NPI
Dong Yub Kim, M.D.
- Anesthesiology Physician
- Ocala, FL
National Provider Identifier
1881765576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- ME82143
- Practice address
- 1431 SW 1St Ave
Ocala, FL 34471-6500 - Phone
- (352) 401-1308
- Fax
- (866) 335-3101
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | ME82143 | FL | Primary |
Addresses
Primary practice location
1431 SW 1St Ave
Ocala, FL 34471-6500
Mailing address
1431 SW 1St Ave
Ocala, FL 34471-6500
Phone (352) 401-1308
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 266186100 | Medicaid | FL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ft. Walton Beach Anesthesia Services LLC | Anesthesiology | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Anesthesiology Physician
- Ft. Walton Beach, FL
- NPI 1245443829
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232409600000",
"number": "1881765576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1431 SW 1ST AVE",
"city": "OCALA",
"state": "FL",
"postal_code": "344716500",
"telephone_number": "352-401-1308",
"fax_number": "866-335-3101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1431 SW 1ST AVE",
"city": "OCALA",
"state": "FL",
"postal_code": "344716500",
"telephone_number": "352-401-1308",
"fax_number": "866-335-3101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "DONG",
"middle_name": "YUB",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2009-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "FL",
"license": "ME82143",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "266186100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ocala, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.