Active NPI
Kellie Jane Lim, M.D.
- Allergy Physician
- Fresno, CA
National Provider Identifier
1134328735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy Physician
- License
- A106613
- Practice address
- 7471 N Fresno St
Fresno, CA 93720-2457 - Phone
- (559) 436-4500
- Fax
- (559) 436-0500
- NPI assigned
- Jul 13, 2007
- 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 |
|---|---|---|---|---|
| Allergy Physician | 207KA0200X | A106613 | CA | Primary |
Addresses
Primary practice location
7471 N Fresno St
Fresno, CA 93720-2457
Mailing address
7471 N Fresno St
Fresno, CA 93720-2457
Phone (559) 436-4500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0043790 | Medicaid | CA | |
| ZZZ21572Z | Other | CA | MEDICARE PTAN |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106613 | CA | MD | Marriage & Family Therapist |
| A106613 | CA | MD | Allergy Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372032000000",
"number": "1134328735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7471 N FRESNO ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937202457",
"telephone_number": "559-436-4500",
"fax_number": "559-436-0500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7471 N FRESNO ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937202457",
"telephone_number": "559-436-4500",
"fax_number": "559-436-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIM",
"first_name": "KELLIE",
"middle_name": "JANE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-13",
"last_updated": "2013-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "207KA0200X",
"taxonomy_group": "",
"desc": "Allergy & Immunology, Allergy",
"state": "CA",
"license": "A106613",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0043790",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "ZZZ21572Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.