Active NPI
Prince S Kim, DPT
- Physical Therapist
- Graham, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1397219
- Practice address
- 10141 224TH St E
Graham, WA 98338-9190 - Phone
- (253) 446-6982
- NPI assigned
- Dec 26, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1397219 | TX | Primary |
| Physical Therapist | 225100000X | PT61600137 | WA |
Addresses
Primary practice location
10141 224TH St E
Graham, WA 98338-9190
Mailing address
6050 Tacoma Mall Blvd Ste 300
Tacoma, WA 98409-6828
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10141 224TH St E
Graham, WA 98338-9190
Phone (253) 446-6982
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1397219 | TX | MD | Physical Therapist |
| PT61600137 | WA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Physical Therapist | Past | Accepting new patients |
Locations
4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590
10141 224th St E
Graham, WA 98338
Phone (253) 240-0315
222 State Ave N
Kent, WA 98030
Phone (253) 372-7680
311 S L St
Tacoma, WA 98405
Phone (253) 403-1444
Organizations & group practices 4
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.
-
- Neurological Surgery Physician
- Tacoma, WA
- NPI 1497766638
-
- Cardiovascular Disease Physician
- Everett, WA
- NPI 1164185765
-
- Community/Retail Pharmacy
- Spokane, WA
- NPI 1396594875
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1735171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735171200000",
"number": "1962210781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6050 TACOMA MALL BLVD STE 300",
"city": "TACOMA",
"state": "WA",
"postal_code": "984096828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10141 224TH ST E",
"city": "GRAHAM",
"state": "WA",
"postal_code": "983389190",
"telephone_number": "253-446-6982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "PRINCE",
"middle_name": "S",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-12-26",
"last_updated": "2024-12-26",
"certification_date": "2024-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1397219",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT61600137",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Graham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; 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.