Sang Tae Caleb Kim (NPI# 1144330762, PAC ID# 5193868719) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1144330762 |
| PAC ID by PECOS | 5193868719 |
| Professional Enrollment ID | I20100204000648 |
| Full Name | Sang Tae Caleb Kim |
| Organization Legal Name | FMC MEDICAL FOUNDATION INC |
| Address |
1616 S Kentucky St Suite 100 Amarillo TX 79102-2252 |
| Phone Number | 8063589400 |
| Gender | M |
| Graduation Year | 1995 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 9133341795 |
| Number of Group Practice Members | 51 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 450231 | BAPTIST ST ANTHONY'S HOSPITAL |
| 450209 | NORTHWEST TEXAS HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1500 S Coulter St, Suite 6, Amarillo, TX 79106-1790 | 8064679777 | FMC MEDICAL FOUNDATION INC |
| 1616 S Kentucky St, Suite 100, Amarillo, TX 79102-2252 | 8063589400 | FMC MEDICAL FOUNDATION INC |
| Organization Legal Name | FMC MEDICAL FOUNDATION INC |
| Physicians | 52 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amanda B. Moss | Nurse Practitioner | Fmc Medical Foundation Inc | 2329 Ross Osage St, Amarillo, TX 79103-3000 |
| Martha Elisa Flores | Nurse Practitioner | Fmc Medical Foundation Inc | 911 23rd St, Canyon, TX 79015-4645 |
| Cecelia G Brewer | Nurse Practitioner | Fmc Medical Foundation Inc | 5807 Sw 45th Ave, Suite 100, Amarillo, TX 79109-5291 |
| Mary Ruth Anderson | Nurse Practitioner | Fmc Medical Foundation Inc | 603 Quail Creek Dr, Spc 300, Amarillo, TX 79124-1647 |
| Tommy W Brian | Nurse Practitioner | Fmc Medical Foundation Inc | 2701 S Georgia St, Amarillo, TX 79109-1979 |
| Jeffery T Whelchel | Family Medicine | Fmc Medical Foundation Inc | 4514 Cornell St, Suite B, Amarillo, TX 79109-5801 |
| James R Russell | Nurse Practitioner | Fmc Medical Foundation Inc | 1400 S Van Buren St, Amarillo, TX 79101-4128 |
| Robert D Gross | Family Medicine | Fmc Medical Foundation Inc | 911 23rd St, Canyon, TX 79015-4645 |
| Zhila Khamisi Asl | Physician Assistant | Fmc Medical Foundation Inc | 911 23rd St, Canyon, TX 79015-4645 |
| David B Clarke | Family Medicine | Fmc Medical Foundation Inc | 1616 S Kentucky St, Suite 100, Amarillo, TX 79102-2252 |
| Street Address |
1616 S KENTUCKY ST SUITE 100 |
| City | AMARILLO |
| State | TX |
| Zip | 79102-2252 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David B Clarke | Family Medicine | Fmc Medical Foundation Inc | 1616 S Kentucky St, Suite 100, Amarillo, TX 79102-2252 |
| Gabriela Benavides | Nurse Practitioner | Fmc Medical Foundation Inc | 1616 S Kentucky St, Suite 100, Amarillo, TX 79102-2252 |
| Elena C Loomis | Nurse Practitioner | Fmc Medical Foundation Inc | 1616 S Kentucky St, Suite 100, Amarillo, TX 79102-2252 |
| James D Hale | Family Medicine | Fmc Medical Foundation Inc | 1616 S Kentucky St, Suite 100, Amarillo, TX 79102-2252 |
| Derrell D Deloach | Nurse Practitioner | Fmc Medical Foundation Inc | 1616 S Kentucky St, Suite 100, Amarillo, TX 79102-2252 |
| Joni Michelle Tversky | Nurse Practitioner | Fmc Medical Foundation Inc | 1616 S Kentucky St, Suite 100, Amarillo, TX 79102-2252 |
| Andrea Nicole Fuller | Physician Assistant | Fmc Medical Foundation Inc | 1616 S Kentucky St, Suite 100, Amarillo, TX 79102-2252 |
| Christina Kimbrell | Nurse Practitioner | Fmc Medical Foundation Inc | 1616 S Kentucky St, Suite 100, Amarillo, TX 79102-2252 |
| Cherity Gwen Mays | Nurse Practitioner | Fmc Medical Foundation Inc | 1616 S Kentucky St, Suite 100, Amarillo, TX 79102-2252 |
| Deni Berry | Nurse Practitioner | Fmc Medical Foundation Inc | 1616 S Kentucky St, Suite 100, Amarillo, TX 79102-2252 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brenda Meeks | Psychologist, Clinical | 1216 S Georgia St, Amarillo, TX 79102-1310 | |
| Jim R Coventry | Clinical Social Worker | 1616 S Kentucky, Suite 125a, Amarillo, TX 79102-2250 | |
| James S Rogers, Jr | Clinical Social Worker | 1616 S Kentucky St, Suite A125, Amarillo, TX 79102-2250 | |
| Dhana R Cox | Family Medicine | Fmc Medical Foundation Inc | 1616 S Kentucky St, Suite 100, Amarillo, TX 79102-2252 |
| Abigail E Pitt | Nurse Practitioner | Fmc Medical Foundation Inc | 1616 S Kentucky St, Suite 100, Amarillo, TX 79102-2252 |
| Jessica Diann Brittain | Nurse Practitioner | Fmc Medical Foundation Inc | 1616 S Kentucky St, Suite 100, Amarillo, TX 79102-2252 |
| Ron K Rankin | Family Medicine | Fmc Medical Foundation Inc | 1616 S Kentucky St, Suite 100, Amarillo, TX 79102-2252 |
| Darrell Kimbrough | Nurse Practitioner | Fmc Medical Foundation Inc | 1616 S Kentucky St, Suite 100, Amarillo, TX 79102-2252 |
| Toni Lambert | Nurse Practitioner | Fmc Medical Foundation Inc | 1616 S Kentucky St, Suite 100, Amarillo, TX 79102-2252 |
| Barbara L Jensen | Nurse Practitioner | Fmc Medical Foundation Inc | 1616 S Kentucky St, Suite 100, Amarillo, TX 79102-2252 |
| Find all physicians in zip 79102 | |||
| City | AMARILLO |
| Zip Code | 79102 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | AMARILLO + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Sang Tae Caleb Kim.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.