Organization Active NPI

KL Goring LLC

  • Sleep Medicine (Internal Medicine) Physician
  • Prince Frederick, MD
National Provider Identifier
1003346404
Registry record updated Jun 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
License
56571 Issued in MD
Legal business name
KL GORING LLC
Practice address
995 Prince Frederick Blvd Ste 101
Prince Frederick, MD 20678-3199
Phone
(410) 414-6550
Fax
(443) 968-9205
NPI assigned
Jun 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kim Lesley Goring, MDNPI 1265404883
Title
Owner
Phone
(240) 223-7308

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RS0012X 56571 MD Primary

Addresses

Primary practice location

995 Prince Frederick Blvd Ste 101
Prince Frederick, MD 20678-3199

Mailing address

9962 Cypress Way
Laurel, MD 20723-6021
Phone (240) 223-7308

Other identifiers 1

IdentifierTypeStateIssuer
1265404883MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171128002900 MD Part B Supplier - Clinic/Group Practice 8426315557 Receives reassigned benefits from 2 practitioners
Practice locations: Prince Frederick, MD

National Provider Directory

National Provider Directory

Locations

995 Prince Frederick Blvd
Ste 10
Prince Frederick, MD 20678

995 Prince Frederick Blvd
Prince Frederick, MD 20678

995 Prince Frederick Blvd
Ste 101
Prnc Frederck, MD 20678
Phone (410) 414-6185

995 Prince Frederick Blvd
Slp Ctr
Prnc Frederck, MD 20678
Phone (410) 414-6185

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497744000000",
    "number": "1003346404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9962 CYPRESS WAY",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207236021",
            "telephone_number": "240-223-7308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 PRINCE FREDERICK BLVD STE 101",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783199",
            "telephone_number": "410-414-6550",
            "fax_number": "443-968-9205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KL GORING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-18",
        "last_updated": "2017-06-18",
        "status": "A",
        "authorized_official_last_name": "GORING",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "LESLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-223-7308",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "MD",
            "license": "56571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265404883",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.