Active NPI
Ji Yeon Lim
- Psychiatric/Mental Health Nurse Practitioner
- New York, NY
National Provider Identifier
1457078685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- F402938
- Practice address
- 224 E 47TH St
New York, NY 10017-2102 - Phone
- (347) 218-0815
- NPI assigned
- Oct 27, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | F402938 | NY | Primary |
Addresses
Primary practice location
224 E 47TH St
New York, NY 10017-2102
Mailing address
9916 62ND Ave FL 2
Rego Park, NY 11374-1470
Phone (718) 747-4675
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 |
|---|---|---|---|
| F402938 | NY | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689206400000",
"number": "1457078685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9916 62ND AVE FL 2",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113741470",
"telephone_number": "718-747-4675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 E 47TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100172102",
"telephone_number": "347-218-0815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIM",
"first_name": "JI",
"middle_name": "YEON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-27",
"last_updated": "2023-07-13",
"certification_date": "2023-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NY",
"license": "F402938",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.