Individual provider Active NPI

Namjoong Kim

  • Chiropractor
  • Seattle, WA
National Provider Identifier
1902533433
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH61313084 Issued in WA
Practice address
9714 3Rd Ave NE Ste 201
Seattle, WA 98115-2000
Phone
(808) 636-7077
Fax
(206) 707-7633
NPI assigned
Aug 4, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH61313084 WA Primary

Addresses

Primary practice location

9714 3Rd Ave NE Ste 201
Seattle, WA 98115-2000

Mailing address

9714 3Rd Ave NE Ste 201
Seattle, WA 98115-2000
Phone (808) 636-7077

Other practice location 1

7315 212th St SW
Edmonds, WA 98026-7610
Phone (425) 361-1839

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230706003768 WA Practitioner - Chiropractic 6709245921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9714 3Rd Ave NE
Suite 201
Seattle, WA 98115-2000
Phone (206) 588-2980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chirolight PLLC Chiropractor CurrentSince Jun 1, 2023 Accepting new patients

Locations

9714 3rd Ave NE
Ste 201
Seattle, WA 98115
Phone (206) 588-2980

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.

NPI Registry JSON

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1902533433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9714 3RD AVE NE STE 201",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981152000",
            "telephone_number": "808-636-7077",
            "fax_number": "206-707-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9714 3RD AVE NE STE 201",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981152000",
            "telephone_number": "808-636-7077",
            "fax_number": "206-707-7633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7315 212th St SW",
            "address_purpose": "LOCATION",
            "city": "Edmonds",
            "state": "WA",
            "postal_code": "980267610",
            "country_code": "US",
            "telephone_number": "425-361-1839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "NAMJOONG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-04",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH61313084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.