Suckhong Brian Kim, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

R5J91 Issued in MO

Practice address

1540 E Evergreen St
Springfield, MO 65803-4300

Phone

(417) 823-2900

Fax

(417) 886-2774

NPI assigned

Jun 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in MO, AR2 enrollments

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 2

Specialty

Pulmonary DiseaseAlso: Internal Medicine

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Citizens Memorial HealthcareGroup PAC ID 4183528169, 144 clinicians

Sgoh Acquisition IncGroup PAC ID 5092616276, 95 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Citizens Memorial Hospital Hospital, Bolivar, MO, CCN 260195
• Ozarks Community Hospital of Gravette Hospital, Gravette, AR, CCN 041331
• Cedar County Memorial Hospital Hospital, El Dorado Springs, MO, CCN 261323
• Cox Medical Centers Hospital, Springfield, MO, CCN 260040

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: s.kim@cernerdirect.coxhealth.com

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.

• Citizens Memorial Healthcare

  • Surgery Physician
  • Bolivar, MO
  • NPI 1568566131
  Medicare reassignment Care Compare group NPD
• Sgoh Acquisition Inc

  • Critical Access Hospital
  • Gravette, AR
  • NPI 1568643005
  Medicare reassignment Care Compare group NPD
• Sgoh Acquisition Inc

  • Clinic/Center
  • Springfield, MO
  • NPI 1114924768
  Medicare reassignment
• Citizens Memorial Healthcare

  • Rural Health Clinic/Center
  • Willard, MO
  • NPI 1568127397
  NPD
• Primrose Nephrology, Inc.

  • Specialist
  • Springfield, MO
  • NPI 1225163116
  NPD
• Edward Gwin M.D., LLC

  • Sleep Medicine (Internal Medicine) Physician
  • Springfield, MO
  • NPI 1639359250
  NPD (past)
• Ferrell Duncan Clinic, Inc

  • Multi-Specialty Clinic/Center
  • Springfield, MO
  • NPI 1326099383
  NPD (past)
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cedar County Memorial Hospital

  • Critical Access Hospital
  • El Dorado Springs, MO
  • NPI 1720039605
  Care Compare affiliation
• Citizens Memorial Hospital District

  • General Acute Care Hospital
  • Bolivar, MO
  • NPI 1003981549
  Care Compare affiliation
• Lester E Cox Medical Centers

  • General Acute Care Hospital
  • Springfield, MO
  • NPI 1093740128
  Care Compare affiliation
• Lester E Cox Medical Centers

  • Land Ambulance
  • Springfield, MO
  • NPI 1114044823

  Hospital

  Care Compare affiliation
• Lester E. Cox Medical Centers

  • Air Ambulance
  • Springfield, MO
  • NPI 1578680286

  Hospital

  Care Compare affiliation
• Sgoh Acquisition Inc

  • Critical Access Hospital
  • Gravette, AR
  • NPI 1568643005
  Care Compare affiliation

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1922041839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 E EVERGREEN ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658034300",
            "telephone_number": "417-823-2900",
            "fax_number": "417-886-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 E EVERGREEN ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658034300",
            "telephone_number": "417-823-2900",
            "fax_number": "417-886-2774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Jackson St SW",
            "address_purpose": "LOCATION",
            "city": "Gravette",
            "state": "AR",
            "postal_code": "727369121",
            "country_code": "US",
            "telephone_number": "479-787-5291",
            "fax_number": "417-344-6404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "SUCKHONG",
        "middle_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MO",
            "license": "R5J91",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039014838",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202657011",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00958203",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922041839",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "107067",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188306001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00361138",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chrystal M. Killinger, FNP-C
• Carol Kim, D.D.S.
• Hee-Sun Kim, MD
• Hyewon Helen Kim, MD
• Jangsoo Kim
• Mary Kathleen Kimball
• Kimberly Wilkins PSYD LLC
• Jennifer Wren Kimbrell, M.D.
• Kimbrough Dental Associates LLC
• Emily L. Kimbrough, PA-C

• Pulmonary Disease Physician in Springfield, MO
• Providers in Springfield, MO by specialty
• Pulmonary Disease Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.