Sunny Kim

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD160582 Issued in OR

Practice address

503 Airport Rd Ste 101
Medford, OR 97504-4159

Phone

(541) 200-2900

Fax

(541) 200-2948

NPI assigned

Jul 2, 2007

Last updated

Dec 1, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

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 1

Specialty

Psychiatry

Education

University of Washington School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fanno Creek Clinic LLCGroup PAC ID 0042100521, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Fanno Creek Clinic LLC

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1609876705
  Medicare reassignment Care Compare group NPD
• Columbiacare Services Inc

  • Psychiatric Residential Treatment Facility
  • Medford, OR
  • NPI 1649466475
  Medicare reassignment NPD
• DHS/Office of Financial Services Irs/Eopc/BMRC/Eotc/Osh/Osh-P

  dba Oregon State Hospital (Salem)

  • Psychiatric Hospital
  • Salem, OR
  • NPI 1508802489
  Medicare reassignment
• Columbiacare Services Inc

  dba Central Clinic

  • Adult Mental Health Clinic/Center
  • Medford, OR
  • NPI 1992223630
  NPD
• Coda, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Seaside, OR
  • NPI 1750912184
  NPD (past)
• Northwest Cancer Specialists PC

  dba Compass Oncology

  • Hematology & Oncology Physician
  • Vancouver, WA
  • NPI 1407828114
  NPD (past)

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1902003080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3587 HEATHROW WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044004",
            "telephone_number": "541-858-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 AIRPORT RD STE 101",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044159",
            "telephone_number": "541-200-2900",
            "fax_number": "541-200-2948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8041 E Burnside St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972151548",
            "country_code": "US",
            "telephone_number": "503-252-3304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "SUNNY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD160582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "endpointDescription": "n/a",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "n/a",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "n/a",
            "address_1": "503 Airport Rd Ste 101",
            "city": "Medford",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975044159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hidong Kim, MD, PHD
• Ji Hyun Kim
• Joseph Chisung Kim, M.D.
• Milton W Kim, MD
• Minji Kim, M.D.
• Megan Kimball, LMSW
• Hannah Jane Kimbel
• Rebecca Ann Kimmel, PHARMD
• King Aesthetics, LLC
• King Health & Wellness, LLC

• Psychiatry Physician in Medford, OR
• Providers in Medford, OR by specialty
• Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.