Active NPI
Kelly Kim
- Pharmacist
- Baltimore, MD
National Provider Identifier
1285031427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21005
- Practice address
- 6301 York Rd
Baltimore, MD 21212-2636 - Phone
- (443) 524-4535
- NPI assigned
- Dec 3, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 21005 | MD | Primary |
| Pharmacist | 183500000X | 0202212706 | VA |
Addresses
Primary practice location
6301 York Rd
Baltimore, MD 21212-2636
Mailing address
207 Westport Bay Dr
Apt 304
Glen Burnie, MD 21061-6380
Phone (443) 570-0960
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 |
|---|---|---|---|
| 21005 | MD | MD | Pharmacist |
| 0202212706 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417651200000",
"number": "1285031427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 WESTPORT BAY DR",
"address_2": "APT 304",
"city": "GLEN BURNIE",
"state": "MD",
"postal_code": "210616380",
"telephone_number": "443-570-0960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6301 YORK RD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212122636",
"telephone_number": "443-524-4535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-03",
"last_updated": "2014-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "21005",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202212706",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.