IL H. KIM (NPI# 1396782314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396782314 |
| Entity Type | Individual |
| Full Name | IL H. KIM |
| Credential | M.D. |
| Practice Address |
100 Jackson Pike Gallipolis OH 45631-1560 |
| Mailing Address |
90 Jackson Pike Gallipolis OH 45631-1560 |
| Practice Telephone | 7404465371 |
| Practice Fax Number | 7404465711 |
| Mailing Telephone | 7404465371 |
| Mailing Fax Number | 7404465711 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2019-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 35.050817 | OH | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 15264 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0556161 | 05 | |
| MOUNTAIN STATE BCBS | 001714043 | 01 | |
| WV | 0112618000 | 05 | |
| RR MEDICARE | 370002076 | 01 | |
| WV | ANTHEM BCBS | 000000006612 | 01 |
| OH | UNISON MEDICAID | 000000181964 | 01 |
| OH | MOLINA MEDICAID | 0556161 | 01 |
| OH | CARESOURCE MEDICAID | 310917085107 | 01 |
| ANTHEM BCBS | 000000007508 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649519760 | Il Gon Kim | Specialist | 4060 Route 220 Hwy, Hughesville, PA 17737-8916 | 2013-02-08 |
| 1447288543 | Il Young Kim | Internal Medicine | 3919 Beverly Blvd, #100, Los Angeles, CA 90004-3432 | 2006-06-28 |
| 1548269061 | Il Bong Kim | Surgery | 151 W High St, Morris, IL 60450-1407 | 2005-07-18 |
| 1982826525 | Il Nam Kim | Contractor | 1485 Spruce St, Suite P, Riverside, CA 92507-2445 | 2007-05-03 |
| 1164403572 | Il Hwan Kim | Orthopaedic Surgery | 457 Jack Martin Blvd, Brick, NJ 08724-7776 | 2005-11-11 |
| Street Address |
100 JACKSON PIKE |
| City | GALLIPOLIS |
| State | OH |
| Zip Code | 45631-1560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407857014 | Robert O. Schmoll Jr. | Pharmacist | 100 Jackson Pike, Gallipolis, OH 45631-1560 | 2005-08-04 |
| 1235740986 | Deborah Pope | Pharmacist | 100 Jackson Pike, Gallipolis, OH 45631-1560 | 2020-08-14 |
| 1407464332 | Emily Nichole Howell | Pharmacist | 100 Jackson Pike, Gallipolis, OH 45631-1560 | 2020-07-16 |
| 1932723020 | Ethan Stephens | Family Medicine | 100 Jackson Pike, Gallipolis, OH 45631-1560 | 2020-06-03 |
| 1528680485 | Umar Razzaq | Student in an Organized Health Care Education/Training Program | 100 Jackson Pike, Gallipolis, OH 45631-1560 | 2020-05-14 |
| 1205458064 | Giovanti Davis | Student in an Organized Health Care Education/Training Program | 100 Jackson Pike, Gallipolis, OH 45631-1560 | 2020-05-14 |
| 1841834488 | Mauja Venugopal Rajan | Nurse Practitioner | 100 Jackson Pike, Gallipolis, OH 45631-1560 | 2019-11-06 |
| 1467094300 | Brian Ly | Pharmacist | 100 Jackson Pike, Gallipolis, OH 45631-1560 | 2019-10-11 |
| 1295388601 | Noah Lee Searls | Pharmacist | 100 Jackson Pike, Gallipolis, OH 45631-1560 | 2019-07-24 |
| 1487206421 | Andrea Rae Roush | Nurse Practitioner | 100 Jackson Pike, Gallipolis, OH 45631-1560 | 2019-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982178703 | Nathaniel D Chapman | Specialist/Technologist | 4th Avenue and Sycamore State, Gallipolis, OH 45631 | 2019-01-15 |
| 1013499029 | Spencer Kissel | Nurse Practitioner | 1284 State Route 160, Gallipolis, OH 45631 | 2018-09-06 |
| 1164940078 | Spring Valley Family Pharmacy LLC | Pharmacy | 448 Jackson Pike Road, Gallipolis, OH 45631 | 2017-08-31 |
| 1831619832 | Crystal N Rankin | Registered Nurse | 471 Paxton Rd, Gallipolis, OH 45631 | 2017-06-21 |
| 1962869685 | Edward Mussi Jr. | Specialist/Technologist | 1051 4th Ave, Gallipolis, OH 45631 | 2016-01-26 |
| 1861822181 | Arbors At Gallipolis | Nursing Facility/Intermediate Care Facility | 170 Pinecrest Drive, Gallipolis, OH 45631 | 2013-11-22 |
| 1619237039 | Mark W. Hasseman | Massage Therapist | 21 Central Avenue, Suite C, Gallipolis, OH 45631 | 2012-05-18 |
| 1730487463 | Elizabeth A Canaday | Nurse Practitioner | 10 Airport Rd, Gallipolis, OH 45631 | 2011-03-03 |
| 1467759456 | Allen Keith Sheets | Dentist | 722 Second Avenue, Gallipolis, OH 45631 | 2011-02-28 |
| 1144398074 | Richard Bowers Simpson | Family Medicine | 49 Ohio Ave, Gallipolis, OH 45631 | 2006-11-30 |
| Find all providers in zip 45631 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093248478 | Jacob Lawrence Pessia | Pediatrics | 100 Jackson Pike, Gallipolis, OH 45631-1560 | 2017-04-04 |
| 1063890200 | Jonathan Mathis | Pediatrics | 100 Jackson Pike, Gallipolis, OH 45631 | 2015-05-08 |
| 1669869566 | Charles Donavan Davis | Pediatrics | 100 Jackson Pike, Gallipolis, OH 45631 | 2015-04-20 |
| 1679913396 | Cassie Ann Rice | Pediatrics | 100 Jackson Pike, Gallipolis, OH 45631-1560 | 2013-06-26 |
| 1255362927 | Danielle T. Cappelletti | Pediatrics | 100 Jackson Pike, Gallipolis, OH 45631-1560 | 2006-07-05 |
| 1053341370 | Jon M. Sullivan | Pediatrics | 100 Jackson Pike, Gallipolis, OH 45631-1560 | 2006-07-03 |
| 1548207392 | Joseph Y. Li | Pediatrics | 90 Jackson Pike, Gallipolis, OH 45631-1560 | 2006-06-01 |
| 1871530840 | Kang K. Lee | Pediatrics | 90 Jackson Pike, Gallipolis, OH 45631-1560 | 2006-05-31 |
| 1821045204 | Richard J. Mendieta | Pediatrics | 100 Jackson Pike, Gallipolis, OH 45631-1560 | 2006-05-30 |
| 1225082670 | Pradeep K. Kandula | Pediatrics | 100 Jackson Pike, Gallipolis, OH 45631-1560 | 2006-05-20 |
| Find all providers in GALLIPOLIS | ||||
| City | GALLIPOLIS |
| Zip Code | 45631 |
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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.