Jin Ho Kim, DOM, AP, LAC, PD.D.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AP2119 Issued in FL

Practice address

321 N Mangoustine Ave
Sanford, FL 32771-1098

Phone

(407) 539-3950

Fax

(407) 539-2661

NPI assigned

Dec 12, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1992865497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 N MANGOUSTINE AVE",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327711098",
            "telephone_number": "407-593-9350",
            "fax_number": "497-539-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N MANGOUSTINE AVE",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327711098",
            "telephone_number": "407-539-3950",
            "fax_number": "407-539-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JIN",
        "middle_name": "HO",
        "name_prefix": "Dr.",
        "credential": "DOM, AP, LAC, PD.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "AP2119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12749100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kids House of Seminole
• Kids House of Seminole, Inc.
• Kim-S Acupuncture Clinic Inc.
• Eileen E Kim, PA-C
• Jeffrey Kim, DPT
• Kendrick Sangyeop Kim
• Diane Kimball
• Kimberly Nelson Kent PHD LLC
• Kimrose Center, LLC
• Kind Hands, Inc.

• Acupuncturist in Sanford, FL
• Providers in Sanford, FL by specialty
• Acupuncturist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; 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.