Active NPI
Hyun Sook Kim, M.D
- Anesthesiology Physician
- Merrillville, IN
National Provider Identifier
1962439711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 01030979A
- Practice address
- 8701 Broadway
Merrillville, IN 46410-7035 - Phone
- (219) 738-4929
- NPI assigned
- Jun 27, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 01030979A | IN | Primary |
Addresses
Primary practice location
8701 Broadway
Merrillville, IN 46410-7035
Mailing address
255 W Michigan Ave
Jackson, MI 49201-2218
Phone (517) 787-6440
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100356660 | Medicaid | IN |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01030979A | IN | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Anesthesiology of Illinois, LLC | Anesthesiology | Past | Accepting new patients |
| Crawford Avenue Anesthesia Provider Services Urbana, LLC | Anesthesiology | Past | Accepting new patients |
| Methodist Anesthesia, LLC | Anesthesiology | 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 and National Provider Directory roles.
-
- Anesthesiology Physician
- Merrillville, IN
- NPI 1326224270
-
- Anesthesiology Physician
- Merrillville, IN
- NPI 1821045410
-
- Anesthesiology Physician
- Urbana, IL
- NPI 1134566615
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438732800000",
"number": "1962439711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 W MICHIGAN AVE",
"city": "JACKSON",
"state": "MI",
"postal_code": "492012218",
"telephone_number": "517-787-6440",
"fax_number": "517-787-4146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8701 BROADWAY",
"city": "MERRILLVILLE",
"state": "IN",
"postal_code": "464107035",
"telephone_number": "219-738-4929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "HYUN",
"middle_name": "SOOK",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-27",
"last_updated": "2015-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IN",
"license": "01030979A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100356660",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Merrillville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.