Lacey Kang, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

R227961 Issued in MD

Practice address

345 Saint Paul St
Baltimore, MD 21202-2123

Phone

(410) 332-9000

NPI assigned

Dec 14, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lkang91865@direct.mdmercy.com

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

• Maryland Family Care, Inc.

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1598718256
  Medicare reassignment NPD

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

{
    "created_epoch": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1346952090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 SAINT PAUL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 SAINT PAUL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022123",
            "telephone_number": "410-332-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "LACEY",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-14",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R227961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Sungme Kang, MD
• Joon-Yi Kang, MD
• Julian Kang, PA-C
• Jun Kang, M.D.
• Kyurim Kang, PHD
• Min Kang, MD
• Ningdong Kang, MD
• Paul Kang, MD
• Sa DO Kang
• Sarah Kang, PHARM.D.

• Pediatric Nurse Practitioner in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Pediatric Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.