Active NPI
Sam Kim, D.C.
- Chiropractor
- Redlands, CA
National Provider Identifier
1932256559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 029632
- Practice address
- 620 Alabama St
Redlands, CA 92373-8059 - Phone
- (909) 792-4434
- NPI assigned
- Jan 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 029632 | CA | Primary |
Addresses
Primary practice location
620 Alabama St
Redlands, CA 92373-8059
Mailing address
PO Box 1129
Redlands, CA 92373-0363
Phone (909) 792-4434
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 029632 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spine & Sport Clinic | Past | Accepting new patients | |
| Morrison Chiropractic Inc | Chiropractor | Past | Accepting new patients |
Organizations & group practices 2
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.
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-
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- Palm Desert, CA
- NPI 1528156072
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1932256559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1129",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923730363",
"telephone_number": "909-792-4434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 ALABAMA ST",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923738059",
"telephone_number": "909-792-4434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SAM",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "029632",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.