Gwang Och Kim, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

35 040705 Issued in OH

Practice address

2819 Hayes Ave
Suite #1
Sandusky, OH 44870-5391

Phone

(419) 627-8403

Fax

(419) 627-1962

NPI assigned

Aug 4, 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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Nephrology Partners of Sandusky Inc

  • Nephrology Physician
  • Sandusky, OH
  • NPI 1164622973
  NPD (past) Authorized official

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

{
    "created_epoch": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1992706543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 PIERCE STREET",
            "address_2": "SUITE D",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "44870",
            "telephone_number": "419-557-5541",
            "fax_number": "419-557-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2819 HAYES AVE",
            "address_2": "SUITE #1",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448705391",
            "telephone_number": "419-627-8403",
            "fax_number": "419-627-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "GWANG",
        "middle_name": "OCH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-04",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "35 040705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "390007082",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000129590",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0364690",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frank W Kickel, MD
• Holly Ann Kidd X
• John Bruce Kijowski, LISW-S
• Laura Kilzer
• Dohee Kim-Appel, PHD IMFT PCC LCDCIII
• William Kimberlin I, PSY.D.
• Raven Seymone Kimbro
• Dakota King-White, PHD
• Max King I, LCDCIII
• Morgan Ashley Kirsch, OTD, OTR/L

• Nephrology Physician in Sandusky, OH
• Providers in Sandusky, OH by specialty
• Nephrology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.