Myung Ja Kang, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

R7005 Issued in MO

Practice address

5535 Delmar Boulevard
Saint Louis, MO 63112-0000

Phone

(314) 879-6363

Fax

(314) 879-6372

NPI assigned

Sep 6, 2005

Last updated

Jul 21, 2011By 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

Other identifiers 1

Other names 1

• Ms. Myung Ja Kim Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Saint Louis Connectcare

  dba St. Louis ConnectCare Endoscopy Center

  • Endoscopy Clinic/Center
  • Saint Louis, MO
  • NPI 1679797237
  NPD (past)

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311206400000",
    "number": "1932193976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5535 DELMAR BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631123005",
            "telephone_number": "314-879-6363",
            "fax_number": "314-879-6372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 DELMAR BOULEVARD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631120000",
            "telephone_number": "314-879-6363",
            "fax_number": "314-879-6372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "MYUNG",
        "middle_name": "JA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-06",
        "last_updated": "2011-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "R7005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201417706",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYUNG",
            "last_name": "KIM",
            "middle_name": "JA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tsuyoshi Kaneko, MD
• Amy Kang, DPT
• Kristine Kang
• Lara Kang, AGACNP
• Liang-I Kang, MD
• Peter Kang, MD
• Sana Saleem Kang, MD
• Victor Kang
• Ivan M Kangrga, MD
• Trent William Kann, PA

• Diagnostic Radiology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Diagnostic Radiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.