SUNGHOON KIM (NPI# 1902833395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902833395 |
| Entity Type | Individual |
| Full Name | SUNGHOON KIM |
| Credential | M.D. |
| Practice Address |
8040 Clearvista Pkwy Ste 340 Indianapolis IN 46256-4673 |
| Mailing Address |
744 52nd St Suite 4100 Oakland CA 94609-1810 |
| Practice Telephone | 3176212660 |
| Mailing Telephone | (510) 428-3022 |
| Mailing Fax Number | 5104283405 |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
01078501A | IN | Allopathic & Osteopathic Physicians |
| N | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
A60075 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 300002154 | 05 | |
| CA | 00A600750 | 05 | |
| IN | MEDICARE | 266180957 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 744 52nd St, Suite 4100, Oakland, CA 946091810 | 5104283022 | 5104283405 |
| Street Address |
8040 CLEARVISTA PKWY STE 340 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46256-4673 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790316859 | Jacob R Weeks | Behavior Technician | 9769 Crosspointed Blvd, Fishers, IN 46256 | 2020-01-28 |
| 1780236620 | Amare Hospice & Palliative Care | Family Medicine | 10475 Crosspoint Boulevard, Suite 250, Indianapolis, IN 46256 | 2019-07-11 |
| 1588226864 | Accutreat LLC | Clinical Medical Laboratory | 9661 Crosspoint Blvd, Indianapolis, IN 46256 | 2019-07-08 |
| 1447732557 | Kathleen O'hara | Marriage & Family Therapist | 8202 Clearvista Pkwy Unit 7, Indianapolis, IN 46256 | 2018-09-05 |
| 1205313608 | Healing Bridges Counseling, LLC | Marriage & Family Therapist | 8465 Keystone Crossing, Suite 266, Indianapolis, IN 46256 | 2018-07-27 |
| 1477062123 | Rosalee Ann Miller | Social Worker | 8202 Clearvista Parkway, Suite 6a, Indianapolis, IN 46256 | 2017-09-26 |
| 1760900039 | Amye Litherland | Registered Nurse | 7525 E. 82nd St Ste A, Indianapolis, IN 46256 | 2017-09-06 |
| 1275074239 | Jason Dempsey | Hearing Instrument Specialist | 8202 Clearvista Pkwy 3a, Indianapolis, IN 46256 | 2017-03-10 |
| 1578922761 | Fresenius Medical Care Indiana, LLC | Clinic/Center | 7155 Shadeland Station Way, Suite 130, Indianapolis, IN 46256 | 2016-02-16 |
| 1477925071 | Samantha Kitcoff | Physician Assistant | 8180 Clearvista Pkwy Ste 100, Indianapolis, IN 46256 | 2015-10-22 |
| Find all providers in zip 46256 | ||||
| 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 |
|---|---|---|---|---|
| 1194081760 | Britney Lynne Grayson | Surgery | 8040 Clearvista Pkwy Ste 460, Indianapolis, IN 46256-4673 | 2012-04-07 |
| 1962592469 | Evan R. Kokoska | Surgery | 2001 W. 86th Street, Pediatric Hospital, Indianapolis, IN 46260 | 2006-10-13 |
| 1790880292 | Pediatric Surgical Associates Inc | Surgery | 250 N Shadeland Ave Ste 200, Indianapolis, IN 46219-4959 | 2006-09-13 |
| 1225464324 | Halkawt Ali Nuri | Surgery | 545 Barnhill Dr, Suite 215, Indianapolis, IN 46202-5112 | 2013-09-20 |
| 1184881641 | Jeremy Herrmann | Surgery | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2008-05-21 |
| 1548317431 | Matthew Landman | Surgery | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2007-01-04 |
| 1811066608 | Robert C Burns | Surgery | 705 Riley Hospital Dr, Ste 2500, Indianapolis, IN 46202-5109 | 2006-11-07 |
| 1699855304 | John W Brown | Surgery | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2006-10-17 |
| 1841393311 | Mark Rodefeld | Surgery | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2006-09-07 |
| 1952416356 | Mark Turrentine | Surgery | 705 Riley Hospital Dr, Indianapolis, IN 46202 | 2006-08-19 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46256 |
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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.