DR. DANIEL KIM (NPI# 1174792154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174792154 |
| Entity Type | Individual |
| Full Name | DR. DANIEL KIM |
| Credential | M.D. |
| Practice Address |
250 Bmh Physicians Office Bldg Maryville TN 37804-5904 |
| Mailing Address |
103 W Broadway Ave Maryville TN 37801-4703 |
| Practice Telephone | 8659805244 |
| Practice Fax Number | 8659805245 |
| Mailing Telephone | 8652731752 |
| Mailing Fax Number | 8652731755 |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2020-05-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | MD54161 | TN | Allopathic & Osteopathic Physicians |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
MD54161 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q022093 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336703743 | Daniel Kim | Student in an Organized Health Care Education/Training Program | 140 Coachman Pl E, Syosset, NY 11791-3053 | 2019-05-01 |
| 1366968679 | Daniel M Kim | Chiropractor | 5597 S Rainbow Blvd Ste 140, Las Vegas, NV 89118-1898 | 2017-08-17 |
| 1427581016 | Daniel Kim | Podiatrist | 3031 W March Ln Unit 310e, Stockton, CA 95219-6500 | 2017-04-10 |
| 1215487673 | Daniel Kim | Pharmacist | 13032 Abing Ave, San Diego, CA 92129-2288 | 2016-10-10 |
| 1699223693 | Daniel C Kim | Chiropractor | 2730 Gallows Rd, Apt 320, Vienna, VA 22180-7476 | 2016-09-19 |
| 1417347006 | Daniel Kim | Dentist | 800 Woodbury Rd Ste B, Woodbury, NY 11797-2503 | 2015-02-03 |
| 1104222140 | Daniel Kim | Acupuncturist | 28229 Ridgepoint Ct, Rancho Palos Verdes, CA 90275-3251 | 2014-11-18 |
| 1528400264 | Daniel S Kim | Dentist | 300 Old Forge Ln, Suite 301, Kennett Square, PA 19348-1897 | 2013-07-23 |
| 1255693297 | Daniel Kim | Student in an Organized Health Care Education/Training Program | 2552 Marron Rd Apt 301, Carlsbad, CA 92010-8397 | 2012-06-14 |
| 1851652382 | Daniel Jiyong Kim | Chiropractor | 1354 The Alameda, Suite 11, San Jose, CA 95126-5000 | 2012-05-31 |
| Street Address |
250 BMH PHYSICIANS OFFICE BLDG |
| City | MARYVILLE |
| State | TN |
| Zip Code | 37804-5904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407899446 | Jennifer M Morton | Nurse Practitioner | 250 Bmh Physicians Office Bldg, Maryville, TN 37804-5904 | 2006-06-14 |
| 1508331455 | Anna Grace Wooten | Physician Assistant | 250 Bmh Physicians Office Bldg, Maryville, TN 37804 | 2018-10-08 |
| 1558758458 | Christina Arp | Nurse Practitioner | 250 Bmh Physicians Office Bldg, Maryville, TN 37804-5904 | 2015-04-20 |
| 1043649031 | Jamie B Monger | Nurse Practitioner | 250 Bmh Physicians Office Bldg, Maryville, TN 37804-5904 | 2013-11-11 |
| 1093026627 | Stephen E Pacifico | Surgery | 250 Bmh Physicians Office Bldg, Maryville, TN 37804-5904 | 2010-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659835825 | Matthew David Mallory | Physical Therapist | Morning View Village 2320 E. Lamar Alexander Parway, Maryville, TN 37804 | 2019-01-22 |
| 1063937290 | Rachel Ryan Mcmillan | Counselor | 362 High Street, Maryville, TN 37804 | 2017-08-09 |
| 1316461460 | Steven Casey Boring | Nurse Practitioner | 907 E. Lamar Alexander Pkwy., Maryville, TN 37804 | 2017-07-31 |
| 1851738751 | Robert Kane Mccall | Pathology | 250 E. Broadway, Maryville, TN 37804 | 2013-05-31 |
| 1619242849 | Jennifer Mcclements | Physical Therapy Assistant | 4004 Samuel Circle, Maryville, TN 37804 | 2012-03-21 |
| 1316223886 | Sabrina Nicole Powers | Social Worker | 1704 East Broadway, Maryville, TN 37804 | 2011-10-28 |
| 1407138381 | Russmann, Inc. | Ambulance | 4163 Benny Delozier Drive, Maryville, TN 37804 | 2011-09-15 |
| 1184932485 | Complete Family Care of Maryville, Pllc | Internal Medicine | 2004 E. Broadway, Maryville, TN 37804 | 2010-09-21 |
| 1093975096 | Kristi Clark Correll | Speech-Language Pathologist | 2030 East Lamar Alexander Parkway, Maryville, TN 37804 | 2008-06-12 |
| 1134388267 | Barbara Frantz Poulsen | Speech-Language Pathologist | 2030 E Lamar Alexander Parkway, Maryville, TN 37804 | 2008-06-04 |
| Find all providers in zip 37804 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801339965 | Msa Alliance, LLC | Surgery | 2016 Vadalabene Dr, Suite B, Maryville, IL 62062-6901 | 2016-11-22 |
| 1003295213 | Msa Alliance, LLC Dba-southern Illinois Vascular and Vein Surgery | Surgery | 6810 State Route 162, Suite 100, Maryville, IL 62062 | 2015-05-20 |
| 1053711895 | Msa Alliance, LLC | Surgery | 2133 Vadalabene Dr, Suite 2, Maryville, IL 62062-5839 | 2014-08-29 |
| 1275604498 | Scott Wong | Surgery | 6810 State Route 162, Ste 105, Maryville, IL 62062-8501 | 2006-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215548375 | Center for Vein Restoration Tn Pllc | Surgery | 6005 Park Ave Ste 225b, Memphis, TN 38119-5207 | 2020-08-12 |
| 1972129534 | Aadi, LLC | Surgery | 7425 Ziegler Rd Ste 101, Chattanooga, TN 37421-4178 | 2020-06-19 |
| 1871002055 | Sumner Physician Practices LLC | Surgery | 225 Big Station Camp Blvd Ste 211, Gallatin, TN 37066-8466 | 2017-09-20 |
| 1679969729 | Jeffrey Thomas Johnston | Surgery | 910 Madison Ave Fl 2, Memphis, TN 38103-3403 | 2015-04-15 |
| 1811330830 | Patrick Yu | Surgery | 1222 Trotwood Ave Ste 211, Columbia, TN 38401-6405 | 2013-04-09 |
| 1578838629 | Karen Parks Rudolph | Surgery | 2108 E 3rd Street, Chattanooga, TN 37404-1622 | 2012-03-21 |
| 1588857148 | James Eric Gardner, Md | Surgery | 400 Market Blvd, Collierville, TN 38017-6516 | 2007-08-27 |
| 1437356482 | Vascular Wellness Center Inc | Surgery | 1720 West Ave Ste 103, Crossville, TN 38555-6066 | 2007-07-02 |
| 1528289808 | Shaun Michael Stickley | Surgery | 1325 Eastmoreland Ave Ste 310, Memphis, TN 38104-7544 | 2007-05-02 |
| 1164598876 | Patrick W Meacham | Surgery | 353 New Shackle Island Rd Suite 348c, Hendersonville, TN 37075 | 2006-11-27 |
| 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.