DR. KENNETH SHIM MD NPI 1063459121

NPI Information

NPI: 1063459121
Provider Name: DR. KENNETH SHIM, MD
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

Address:
55 SPINDRIFT DR
WILLIAMSVILLE, NY
ZIP 14221
Phone: (716) 631-2500
Get Directions

DR. Kenneth Shim, MD is a diagnostic radiology radiology in Williamsville, NY. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. DR. Kenneth Shim, MD NPI is 1063459121. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

55 SPINDRIFT DR
WILLIAMSVILLE, NY
ZIP 14221-800
Phone: (716) 631-2500
Fax: (716) 631-1249

The enumeration date for this NPI number is 5/31/2006 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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	2085R0202X	Radiology	Diagnostic Radiology	1143771	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	040426000699	OTHER	NEW YORK	FIDELIS
2	C72578	MEDICARE ID-TYPE UNSPECIFIED	NEW YORK	MCR
3	01247781	MEDICAID	NEW YORK
4	000511051001	OTHER	NEW YORK	BCBS
5	0005889	OTHER	NEW YORK	GHI
6	D53307	MEDICARE UPIN	NEW YORK
7	1603657	OTHER	NEW YORK	IHA
8	00027013201	OTHER	NEW YORK	UNIVERA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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