NPIMap

Organization Active NPI

Doctor K LLC

  • Family Medicine Physician
  • Ellicott City, MD
National Provider Identifier
1225536915
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D51586 Issued in MD
Legal business name
DOCTOR K LLC
Practice address
5074 Dorsey Hall Dr Ste 104
Ellicott City, MD 21042-7794
Phone
(443) 766-3332
NPI assigned
Jan 27, 2018
Last updated
Feb 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Authorized official

Name
Victor Y Kim, M.D.NPI 1629092465
Title
Owner
Phone
(443) 570-8035

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X D51586 MD Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

5074 Dorsey Hall Dr Ste 104
Ellicott City, MD 21042-7794

Mailing address

5074 Dorsey Hall Dr Ste 104
Ellicott City, MD 21042-7794
Phone (443) 766-3332

Other identifiers 1

IdentifierTypeStateIssuer
416570500MedicaidMD

National Provider Directory

National Provider Directory

Locations

5074 Dorsey Hall Dr
Ste 104
Ellicott City, MD 21042
Phone (301) 596-5733

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1517011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738800000000",
    "number": "1225536915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5074 DORSEY HALL DR STE 104",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427794",
            "telephone_number": "443-766-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5074 DORSEY HALL DR STE 104",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427794",
            "telephone_number": "443-766-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTOR K LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-27",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-570-8035",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D51586",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "416570500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; 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.