Individual provider Active NPI

Joseph Bumsin Kim, D.C., L. AC.

  • Chiropractor
  • Fullerton, CA
National Provider Identifier
1952408817
Registry record updated Feb 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
29975 Issued in CA
Practice address
4128W Commonwealth Ave 101
Fullerton, CA 92833-2565
Phone
(714) 525-3535
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 11131 CA
Chiropractor 111N00000X 29975 CA Primary

Addresses

Primary practice location

4128W Commonwealth Ave 101
Fullerton, CA 92833-2565

Mailing address

4128W Commonwealth Ave 101
Fullerton, CA 92833-2565
Phone (714) 525-3535

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111205000227 CA Practitioner - Chiropractic 0840473328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4128 W Commonwealth Ave
Suite 101
Fullerton, CA 92833-2565
Phone (714) 525-3535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11131CAMDMassage Therapist
29975CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Heermance Family Chiropractic, Inc. Chiropractor PastSince Jul 25, 2015 Accepting new patients
Medihand Acupuncture, Inc Acupuncturist Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1952408817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4128W COMMONWEALTH AVE 101",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928332565",
            "telephone_number": "714-525-3535",
            "fax_number": "714-525-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4128W COMMONWEALTH AVE 101",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928332565",
            "telephone_number": "714-525-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOSEPH",
        "middle_name": "BUMSIN",
        "name_prefix": "Dr.",
        "credential": "D.C., L. AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "11131",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "29975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; 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.