Tony Kyungsoo Kim, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC27102 Issued in CA

Practice address

2100 Market St
Suite 100
Charlestown, IN 47111-9535

Phone

(502) 244-9859

Fax

(770) 573-9513

NPI assigned

May 23, 2005

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Keith Mark Gross MD Inc

  • Dermatology Physician
  • Victorville, CA
  • NPI 1871658278
  NPD (past)
• Osf Medical Group of California, Inc

  • Orthopaedic Surgery Physician
  • Santa Barbara, CA
  • NPI 1629198742
  NPD (past)

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1952304016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24318 HEMLOCK AVE",
            "address_2": "E5",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925577222",
            "telephone_number": "951-485-1918",
            "fax_number": "951-346-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MARKET ST",
            "address_2": "SUITE 100",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471119535",
            "telephone_number": "502-244-9859",
            "fax_number": "770-573-9513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "TONY",
        "middle_name": "KYUNGSOO",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC27102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA LICENSE",
            "identifier": "08002884A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph H Beaven, MD
• Shefali A Kapadia, M.D.
• Sandra Lane Kapso, NP
• Sara Elizabeth Key, LMHC
• Audriana Nicole Kidwell, CMA
• Connie King
• Sarah Lynn King
• Carrie Kirk
• Knipperx Inc.
• Jennifer S Kramp, P.T., M.S.

• Chiropractor in Charlestown, IN
• Providers in Charlestown, IN by specialty
• Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; 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.