Individual provider Active NPI

Kimberly Ann Lim

  • Family Nurse Practitioner
  • Laurel, MD
National Provider Identifier
1437608767
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R181809 Issued in MD
Practice address
9270 Livery LN Apt R
Laurel, MD 20723-1619
Phone
(714) 519-4658
NPI assigned
Sep 28, 2016
Last updated
Sep 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R181809 MD Primary

Addresses

Primary practice location

9270 Livery LN Apt R
Laurel, MD 20723-1619

Mailing address

9270 Livery LN Apt R
Laurel, MD 20723-1619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161219001935 DC Practitioner - Nurse Practitioner 0749561348 Reassigns benefits to 1 organization
I20170113002020 MD Practitioner - Nurse Practitioner 0749561348 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Della Behavioral Health Services CurrentSince Aug 8, 2019 Accepting new patients

Locations

9841 Broken Land Pkwy
Ste 314
Columbia, MD 21046
Phone (410) 929-7225

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1475020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1437608767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9270 LIVERY LN APT R",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207231619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9270 LIVERY LN APT R",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207231619",
            "telephone_number": "714-519-4658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-28",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R181809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.