Robert B.H. Kim, MD MBA

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

17588-020 Issued in WI

Practice address

1055 Prairie Dr # D
Racine, WI 53406-3971

Phone

(262) 898-7100

Fax

(262) 898-7171

NPI assigned

Jul 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration, 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.

• Ascension Medical Group-Fox Valley Wisconsin, Inc

  • Cardiovascular Disease Physician
  • Appleton, WI
  • NPI 1831890177
  NPD (past)
• Radiology Associates of the Fox Valley, SC

  • Diagnostic Radiology Physician
  • Neenah, WI
  • NPI 1477539443
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1992726491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2985 FORESTVIEW CIR",
            "city": "FRANKSVILLE",
            "state": "WI",
            "postal_code": "531269606",
            "telephone_number": "262-835-1308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 PRAIRIE DR # D",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534063971",
            "telephone_number": "262-898-7100",
            "fax_number": "262-898-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ROBERT",
        "middle_name": "B.H.",
        "name_prefix": "Dr.",
        "credential": "MD MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "17588-020",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31176300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adel Khdour, MD
• Abigail Kibler
• Cynthia Ann Kickland
• Janet E. Kieslich, N.P.
• Daniel Yeil Kim, D.M.D.
• Debra Candy Kimaiga, LCSW, LPC, ICS
• Kind Dentistry LLC
• Kimberly A Kind-Bauer, DDS
• Nathalie Anne King, PA
• Sherri King, RN

• Diagnostic Radiology Physician in Racine, WI
• Providers in Racine, WI by specialty
• Diagnostic Radiology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.