Active NPI
Jae Min Kim
- Chiropractor
- New York, NY
National Provider Identifier
1962945204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X012718-1
- Practice address
- 800 2ND Ave RM 806
New York, NY 10017-9223 - Phone
- (703) 500-8763
- NPI assigned
- Nov 18, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X012718-1 | NY | Primary |
Addresses
Primary practice location
800 2ND Ave RM 806
New York, NY 10017-9223
Mailing address
440 Sylvan Ave Ste 135
Englewood Cliffs, NJ 07632-2727
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X012718-1 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479427200000",
"number": "1962945204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 SYLVAN AVE STE 135",
"city": "ENGLEWOOD CLIFFS",
"state": "NJ",
"postal_code": "076322727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 2ND AVE RM 806",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100179223",
"telephone_number": "703-500-8763"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JAE MIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-11-18",
"last_updated": "2016-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X012718-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.