KEVIN KIM (NPI# 1679081673) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679081673 |
| Entity Type | Individual |
| Full Name | KEVIN KIM |
| Credential | DPT |
| Practice Address |
12158 Central Ave Mitchellville MD 20721-1932 |
| Mailing Address |
10635 Gramercy Pl Unit 240 Columbia MD 21044-3098 |
| Practice Telephone | 8555460971 |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2018-01-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518426535 | Kevin Kim | Student in an Organized Health Care Education/Training Program | 12361 E 17th Ave, Room 2004, Aurora, CO 80045 | 2019-03-19 |
| 1669993119 | Kevin Yongkwan Kim | Acupuncturist | 14464 Orange Grove Ave, Hacienda Heights, CA 91745-2557 | 2017-07-05 |
| 1396942058 | Kevin Yunsang Kim | Acupuncturist | 8033 Corporate Center Dr Ste 400, Charlotte, NC 28226-4549 | 2007-06-27 |
| 1346468618 | Kevin Kim | Dentist | 201 University Oaks Ste 770, Round Rock, TX 78665-2422 | 2007-04-23 |
| 1790848471 | Kevin Kim | Dentist | Kim, Jung, Stevens, Stevens, Dds Ps, 6001 100th St Sw, Lakewood, WA 98499-2733 | 2006-12-18 |
| 1104994557 | Kevin C Kim | Family Medicine | 3663 W 6th St # Suit302, Los Angeles, CA 90020-3049 | 2006-12-02 |
| 1851485056 | Kevin B. Kim | Internal Medicine | 2100 Webster St Ste 326, San Francisco, CA 94115-2378 | 2006-10-03 |
| 1942838370 | Kevin Kim | Student in an Organized Health Care Education/Training Program | 30 Prospect Ave, Hackensack, NJ 07601-1915 | 2020-03-31 |
| 1831680750 | Kevin Minsung Kim | Dentist | 1717 Olympia Way, Longview, WA 98632-3929 | 2018-05-26 |
| 1134626047 | Kevin Young Kim | Student in an Organized Health Care Education/Training Program | 11234 Anderson St, Loma Linda, CA 92354-2804 | 2018-04-07 |
| Street Address |
12158 CENTRAL AVE |
| City | MITCHELLVILLE |
| State | MD |
| Zip Code | 20721-1932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619976438 | William F Duboyce | Internal Medicine | 12158 Central Ave, Mitchellville Plaza, Mitchellville, MD 20721-1932 | 2005-07-14 |
| 1487269379 | Jennifer Ann Schmith | Student in an Organized Health Care Education/Training Program | 12158 Central Ave, Mitchellville, MD 20721-1932 | 2020-09-09 |
| 1447880406 | Adrienne Nicole Tolson | Occupational Therapist | 12158 Central Ave, Mitchellville, MD 20721-1932 | 2020-01-18 |
| 1871135988 | Katherine Grove | Physical Therapy Assistant | 12158 Central Ave, Mitchellville, MD 20721-1932 | 2019-10-09 |
| 1760049480 | Jeffy Mary Mathew | Physical Therapist | 12158 Central Ave, Mitchellville, MD 20721-1932 | 2019-05-29 |
| 1801354873 | Jillian Pavlacka | Student in an Organized Health Care Education/Training Program | 12158 Central Ave, Mitchellville, MD 20721-1932 | 2019-03-07 |
| 1497228225 | Alexa Mammen | Student in an Organized Health Care Education/Training Program | 12158 Central Ave, Mitchellville, MD 20721-1932 | 2019-01-03 |
| 1205302973 | Kenny Gaston | Student in an Organized Health Care Education/Training Program | 12158 Central Ave, Mitchellville, MD 20721-1932 | 2018-10-19 |
| 1558858175 | Stephanie M Palacios | Physical Therapist | 12158 Central Ave, Mitchellville, MD 20721-1932 | 2018-04-19 |
| 1154825925 | Jasmin Estefani Casco Nataren | Student in an Organized Health Care Education/Training Program | 12158 Central Ave, Mitchellville, MD 20721-1932 | 2018-03-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124683768 | Lucie Bakop | Nurse Practitioner | 1217 Kingsbury Drive, Bowie, MD 20721 | 2019-05-09 |
| 1699245258 | Rita Nkilo Chofong | Home Health Aide | 1810 Sahara Lane, Bowie, MD 20721 | 2018-11-27 |
| 1215416136 | Mbah Charles | Home Health Aide | 3705 Clayton Dr, Bowie, MD 20721 | 2018-08-10 |
| 1730678061 | Isabell Home Care Assisted Living LLC | Assisted Living Facility | 11609 Candor Drive, Bowie, MD 20721 | 2018-05-02 |
| 1619486974 | Orthatech Inc | Durable Medical Equipment & Medical Supplies | 12138 Central Ave #777, Suite 961, Mitchelville, MD 20721 | 2017-09-29 |
| 1780103994 | Rosefidelis Omnicare, LLC | Registered Nurse | 3815 Alta Vista Drive, Bowie, MD 20721 | 2017-09-19 |
| 1013436070 | Adisatu Renner | Counselor | 4202 Taverngreen Lane, Bowie, MD 20721 | 2017-09-11 |
| 1730607375 | Hope Inyamah Coston | Student in an Organized Health Care Education/Training Program | 12158 Central Avenue, Mitchellville, MD 20721 | 2017-09-05 |
| 1982121463 | Awal A Aziz | Specialist/Technologist, Other | 14303 Duncannon Court, Bowie, MD 20721 | 2017-08-25 |
| 1851841555 | Emmanuel K Tanyi | Home Health Aide | 10971 Spyglass Hill, Bowie, MD 20721 | 2016-10-06 |
| Find all providers in zip 20721 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417318452 | Select Physical Therapy Holdings, Inc. | Clinic/Center | 12164 Central Ave, Suite 212, Mitchellville, MD 20721-1944 | 2016-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144821307 | My Concierge Pt LLC | Clinic/Center | 9141 Gracious End Ct Apt 104, Columbia, MD 21046-2095 | 2020-11-04 |
| 1730794967 | Lz Pt and Wellness, LLC | Clinic/Center | 8375 Jumpers Hole Rd Ste 202, Millersville, MD 21108-1271 | 2020-09-14 |
| 1083224877 | Silver Lining Physical Therapy & Wellness | Clinic/Center | 7050 Oakland Mills Rd Ste 130, Columbia, MD 21046-2269 | 2020-08-06 |
| 1790302925 | Hanson Physical Therapy & Sports Performance | Clinic/Center | 750 State Route 3 S Ste 5, Gambrills, MD 21054-1306 | 2020-07-03 |
| 1891312575 | Flamm Physical Therapy and Wellness, LLC | Clinic/Center | 2801 Guilford Ave, Baltimore, MD 21218-5485 | 2020-06-29 |
| 1073139036 | Woo Physical Therapy and Wellness | Clinic/Center | 8247 Hickory Hollow Dr, Glen Burnie, MD 21060-8721 | 2020-06-24 |
| 1851917892 | Mgpt, LLC | Clinic/Center | 5901 Montrose Rd Apt N402, Rockville, MD 20852-4729 | 2020-06-24 |
| 1811513278 | Manigault Enterprise, L.L.C. | Clinic/Center | 2103 Woodtop Way, Bel Air, MD 21015-6370 | 2020-06-22 |
| 1114543089 | True Sports Physical Therapy, LLC | Clinic/Center | 9030 State Route 108 Ste B, Columbia, MD 21045-1990 | 2020-06-17 |
| 1427673482 | True Sports Physical Therapy, LLC | Clinic/Center | 1305 Governors Ct Ste D, Abingdon, MD 21009-2345 | 2020-06-15 |
| Find all providers with the same taxonomy | ||||
| City | MITCHELLVILLE |
| Zip Code | 20721 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.