Edward Joseph Kimlin, MD

Primary specialty

Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X

License

D0070302 Issued in MD

Practice address

11915 Georgia Ave
Wheaton, MD 20902-2065

Phone

(301) 942-4505

Fax

(301) 942-4509

NPI assigned

Jun 17, 2008

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ekimlin182338@direct.mmc.mainehealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  NPD (past)
• Peninsula Radiological Associates Limited

  • Diagnostic Radiology Physician
  • Newport News, VA
  • NPI 1114030426
  NPD (past)

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1134380702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11915 GEORGIA AVE",
            "city": "WHEATON",
            "state": "MD",
            "postal_code": "209022065",
            "telephone_number": "301-942-4505",
            "fax_number": "301-942-4509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11915 GEORGIA AVE",
            "city": "WHEATON",
            "state": "MD",
            "postal_code": "209022065",
            "telephone_number": "301-942-4505",
            "fax_number": "301-942-4509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMLIN",
        "first_name": "EDWARD",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "MD",
            "license": "D0070302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA LICENSE",
            "identifier": "0101251540",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE",
            "identifier": "D0070302",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Keefe, MD
• David Ivor Kepner, O.D.
• Khalfani Walker, DMD, LLC (Elite Dental Center)
• Wajeed Khan, M.D.
• Kidz & Family Dental Center
• Gregorio Koss, M.D.,FACC.
• Peter J Kotz, ATC
• Sarah Calvert Lartey, CPNP-PC
• Mary Patricia Lazarek, CRNP
• Chul J Lee, MD

• Sports Medicine (Emergency Medicine) Physician in Wheaton, MD
• Providers in Wheaton, MD by specialty
• Sports Medicine (Emergency Medicine) Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.