Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Soo Chan Kim

Individual provider Physical Therapist · NPI 1609752666

Soo Chan Kim is a Physical Therapist in Private Practice in Reston, Virginia. Qualified in 2025, 1 year ago. Licensed in Virginia.

Years since qualifying
1
Licensed in
VA
In the registry since
2025
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Practice location Address checks out

11490 Commerce Park Dr Ste 412
Reston, VA 20191-1590
Phone: (703) 564-4636
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 2305217403 (VA)

Record details

NPI number1609752666
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 14, 2025
Last updated in NPPESOctober 8, 2025
Certification dateOctober 8, 2025
Mailing address11490 Commerce Park Dr Ste 412, Reston, VA 20191-1590

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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