DR. JOHN K. KIM, M.D. - NPI NUMBER 1053472159

Summary

Provider Name: DR. JOHN K. KIM, M.D.

NPI Number: 1053472159

Clasification: Internal Medicine (207R00000X)

Organization: LANDMARK INTERNAL MEDICINE LLC

Address:
6300 STEVENSON AVE
SUITE B
ALEXANDRIA, VA
ZIP 22304

Phone Number: (703) 370-0778



Detailed Information

DR. John K. Kim, M.D. is an internist in Alexandria, VA with 19 years of experience. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. The assigned NPI number for this provider is 1053472159 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE
Graduation Year: 1995

The provider's business address is:

6300 STEVENSON AVE
SUITE B
ALEXANDRIA, VA
ZIP 22304-576
Phone: (703) 370-0778
Fax: (703) 212-7083

The enumeration date for this NPI number is 12/12/2006 and was last updated on 12/1/2009.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 207R00000X Internal Medicine 0101230358 VA Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 5867231 MEDICAID VA
2 H48460 MEDICARE UPIN VA
3 00A674105 MEDICARE ID-TYPE UNSPECIFIED VA
4 P00014196 OTHER DC PALMETTO MEDICARE RAILROAD

NPI Record

No. Field Name Field Value
1 NPI 1053472159
2 Entity Type Code 1
3 Provider Last Name Legal Name KIM
4 Provider First Name JOHN
5 Provider Middle Name K.
6 Provider Name Prefix Text DR.
7 Provider Credential Text M.D.
8 Provider First Line Business Practice Location Address 6300 STEVENSON AVE
9 Provider Second Line Business Practice Location Address SUITE B
10 Provider Business Practice Location Address City Name ALEXANDRIA
11 Provider Business Practice Location Address State Name VA
12 Provider Business Practice Location Address Postal Code 223043576
13 Provider Business Practice Location Address Country Code If outside U S US
14 Provider Business Practice Location Address Telephone Number 7033700778
15 Provider Business Practice Location Address Fax Number 7032127083
16 Provider Enumeration Date 12/12/2006
17 Last Update Date 12/1/2009
18 Provider Gender Code M
19 Healthcare Provider Taxonomy Code 1 207R00000X
20 Provider License Number 1 0101230358
21 Provider License Number State Code 1 VA
22 Healthcare Provider Primary Taxonomy Switch 1 Y
23 Other Provider Identifier 1 5867231
24 Other Provider Identifier Type Code 1 05
25 Other Provider Identifier State 1 VA
26 Other Provider Identifier 2 H48460
27 Other Provider Identifier Type Code 2 02
28 Other Provider Identifier State 2 VA
29 Other Provider Identifier 3 00A674105
30 Other Provider Identifier Type Code 3 04
31 Other Provider Identifier State 3 VA
32 Other Provider Identifier 4 P00014196
33 Other Provider Identifier Type Code 4 01
34 Other Provider Identifier State 4 DC
35 Other Provider Identifier Issuer 4 PALMETTO MEDICARE RAILROAD
36 Is Sole Proprietor Y

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This page was last updated on: 9/11/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.