Individual provider Active NPI

Mikael Woo Kim, D.C.

  • Chiropractor
  • Duluth, GA
National Provider Identifier
1942491352
Registry record updated Jul 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR009239 Issued in GA
Practice address
2472 Pleasant Hill Rd
203A
Duluth, GA 30096-1746
Phone
(770) 623-9229
NPI assigned
Aug 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC29501 CA
Chiropractor 111N00000X CHIR009239 GA Primary

Addresses

Primary practice location

2472 Pleasant Hill Rd
203A
Duluth, GA 30096-1746

Mailing address

2472 Pleasant Hill Rd
203A
Duluth, GA 30096-1746
Phone (770) 623-9229

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140813000148 GA Practitioner - Chiropractic 5991895450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2472 Pleasant Hill Rd
203A
Duluth, GA 30096-1746

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC29501CAMDChiropractor
CHIR009239GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dana Health and Wellness Center Inc CurrentSince May 1, 2014 Accepting new patients
Michael D Phillips, MD Medical Corporation Past Accepting new patients
Won Sung Chiropractic Clinic, Inc Chiropractor PastSince Jul 11, 2015 Accepting new patients
Dana Health and Wellness Center Inc Chiropractor Past Accepting new patients
Alleviate Wellness Center of Nelson Lee Chiropractic Corporation Chiropractor Past Accepting new patients

Locations

2472 Pleasant Hill Rd
Ste 203A
Duluth, GA 30096
Phone (770) 623-9229

Organizations & group practices 5

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": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405296000000",
    "number": "1942491352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2472 PLEASANT HILL RD",
            "address_2": "203A",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961746",
            "telephone_number": "770-623-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2472 PLEASANT HILL RD",
            "address_2": "203A",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961746",
            "telephone_number": "770-623-9229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MIKAEL",
        "middle_name": "WOO",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-09",
        "last_updated": "2014-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC29501",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; 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.