STEPHEN S KIM (NPI# 1942390836) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942390836 |
| Entity Type | Individual |
| Full Name | STEPHEN S KIM |
| Credential | M.D. |
| Practice Address |
2730-c Prosperity Avenue Fairfax VA 22031 |
| Practice Telephone | 7035602236 |
| Mailing Telephone | 7035602236 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2016-06-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
0101243334 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| INTERNAL ID-MOTOR VEHICLE ID | 279750 | 01 | |
| WA | 8390668 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912444779 | Stephen Kim | Specialist/Technologist | 175 Sam Sibley Dr., Natchitoches, LA 71457 | 2017-01-31 |
| 1265765473 | Stephen Joseph Kim | Dentist | 1200 112th Ave Ne Ste B275, Bellevue, WA 98004-3738 | 2009-09-08 |
| 1043434483 | Stephen Hojong Kim | Dentist | 4061 Kirkpatrick Ln, Suite 100, Flower Mound, TX 75028 | 2007-04-13 |
| 1760539068 | Stephen Sae Chang Kim | Family Medicine | 177 Mouse Creek Rd Nw, Cleveland, TN 37312-3838 | 2007-01-05 |
| 1659449791 | Stephen Kim | Dentist | 7841 Commonwealth Ave, Buena Park, CA 90621-2422 | 2006-11-30 |
| 1376563403 | Stephen Alan Kim | Family Medicine | 3140 Legacy Dr Ste 720, Frisco, TX 75034-7917 | 2006-07-20 |
| 1740226893 | Stephen S Kim | Internal Medicine | 222 Ne Park Plaza Dr, Suite 100, Vancouver, WA 98684-5895 | 2006-06-20 |
| 1558909408 | Stephen Kim | Pharmacist | 1540 E Highland Ave, San Bernardino, CA 92404-4614 | 2019-12-11 |
| 1285175109 | Stephen Kim | Orthotist | 2434 W Peterson Ave, Chicago, IL 60659-4113 | 2017-03-10 |
| 1851750400 | Stephen Kim | Dentist | 5545 E Broadway Blvd Ste 107, Tucson, AZ 85711 | 2016-02-10 |
| Street Address |
2730-C PROSPERITY AVENUE |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699863308 | Fairfax Neonatal Associates, P.C. | Pediatrics | 2730-c Prosperity Avenue, Fairfax, VA 22031 | 2006-10-10 |
| 1609248012 | Megan Dushek | Nurse Practitioner | 2730-c Prosperity Avenue, Fairfax, VA 22031 | 2015-10-25 |
| 1033432539 | Julie-ann M Crewalk | Pediatrics | 2730-c Prosperity Avenue, Fairfax, VA 22031 | 2010-03-11 |
| 1841461266 | Fairfax Neonatal Associates, P.C. | Pediatrics | 2730-c Prosperity Avenue, Fairfax, VA 22031 | 2008-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902414105 | Su Jung Kang | Dentist | 9661-c Main Street, Fairfax, VA 22031 | 2020-07-14 |
| 1346896347 | Fuling Guo | Acupuncturist | 3013 James St, Fairfax, VA 22031 | 2019-08-15 |
| 1902458797 | Kayla Callister | Psychologist | 2270 Willow Oaks Corporate Drive, Fairfax, VA 22031 | 2019-07-11 |
| 1790349801 | Fairfax Dental Esthetics | Dentist | 9621 Fairfax Blvd., Fairfax, VA 22031 | 2019-04-24 |
| 1417427675 | Kathryn Yen Ho | Speech-Language Pathologist | 8270 Willow Oaks Corporate Drive Suite 2127, Falls Church, VA 22031 | 2018-11-30 |
| 1932681376 | Joanne Towers | Physician Assistant | 3025 Hamaker Court Suite 300, Fairfax, VA 22031 | 2018-09-01 |
| 1790262020 | S Renee Dennis | Nurse Practitioner | 8316 Arlington Blvd Ste 500, Fairfax, VA 22031 | 2018-07-19 |
| 1013493451 | Elizabeth Joan Dwyer | Physician Assistant | 3023 Hamaker Ct., Suite 500, Fairfax, VA 22031 | 2018-07-18 |
| 1316432669 | Delta Pharm LLC | Pharmacy | 8316 Arlington Blvd Ste 100, Fairfax, VA 22031 | 2018-06-28 |
| 1629567656 | Laura Breeden | Acupuncturist | 3846 Lyndhurst Dr Apt 301, Fairfax, Va, VA 22031 | 2018-05-04 |
| Find all providers in zip 22031 | ||||
| Taxonomy Code | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306074323 | Iljana Marjorie Gaffar | Surgery | 2730 Prosperity Ave Ste C, Fairfax, VA 22031 | 2009-06-29 |
| 1811275407 | Bharath Dwaraka Nath | Surgery | 2730 Prosperity Ave Ste C, Fairfax, VA 22031 | 2011-07-29 |
| 1700088242 | Fairfax Neonatal Associates, PC | Surgery | 2730 Prosperity Ave, Ste C, Fairfax, VA 22031-4329 | 2007-06-05 |
| 1700095916 | Joseph Edmond Hartwich | Surgery | 2730 Prosperity Ave Ste B, Fairfax Neonatal Associates, Fairfax, VA 22031-4324 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568063196 | Madeleine Holden Snidow | Surgery | 3760 Reeds Landing Cir, Midlothian, VA 23113-1369 | 2020-11-02 |
| 1649884719 | Amal Y Elkhatib | Surgery | 2914 Myrtlewood Dr, Dumfries, VA 22026-2202 | 2020-09-04 |
| 1215926332 | Richmond Pediatric Surgeons LLC | Surgery | 7115 Jahnke Rd, Richmond, VA 23225-4017 | 2005-10-20 |
| 1811160971 | Daniel E. Levin | Surgery | 1204 W Main St, Charlottesville, VA 22903-2824 | 2008-04-10 |
| 1629192836 | Laura Anne Boomer | Surgery | 1250 E Marshall St, Richmond, VA 23298-5051 | 2007-03-16 |
| 1063546869 | Bradley M. Rodgers | Surgery | Uva Hospital W, Hospital Drive, Charlottesville, VA 22908-0001 | 2007-03-15 |
| 1992839716 | Eugene D. Mcgahren IIi | Surgery | 1204 W Main St, Charlottesville, VA 22903-2824 | 2007-03-15 |
| 1295829125 | Patricia A Lange | Surgery | 1250 E Marshall Street, Richmond, VA 23298-0510 | 2006-10-03 |
| 1245248947 | Children's Surgical Specialty Group, Inc | Surgery | 171 Kempsville Rd, Suite 201, Norfolk, VA 23502-4700 | 2006-08-04 |
| 1396752838 | Robert E. Kelly Jr. | Surgery | 601 Childrens Ln, Norfolk, VA 23507-1910 | 2006-08-01 |
| Find all providers with the same taxonomy | ||||
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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.