Active NPI
Jiin Kim
- Behavior Analyst
- Sterling, VA
National Provider Identifier
1093424301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- A62409134
- Practice address
- 45305 Catalina CT Building B, Ste 101
Sterling, VA 20166 - Phone
- (571) 441-3177
- NPI assigned
- Nov 16, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | A62409134 | VA | Primary |
Addresses
Primary practice location
45305 Catalina CT Building B, Ste 101
Sterling, VA 20166
Mailing address
45305 Catalina CT Building B, Ste 101
Sterling, VA 20166
Phone (571) 441-3177
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A62409134 | VA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668556800000",
"number": "1093424301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45305 CATALINA CT BUILDING B, STE 101",
"city": "STERLING",
"state": "VA",
"postal_code": "20166",
"telephone_number": "571-441-3177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45305 CATALINA CT BUILDING B, STE 101",
"city": "STERLING",
"state": "VA",
"postal_code": "20166",
"telephone_number": "571-441-3177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JIIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-16",
"last_updated": "2022-11-16",
"certification_date": "2022-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "VA",
"license": "A62409134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sterling, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.