Active NPI
Jenny Kim, MD
- Hematology & Oncology Physician
- Baltimore, MD
National Provider Identifier
1629244389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- D70993
- Practice address
- 1650 Orleans St
CRB 1 RM 443
Baltimore, MD 21287-0013 - Phone
- (410) 614-3977
- Fax
- (410) 614-8160
- NPI assigned
- May 2, 2008
- 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 |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | 57.014085 | OH | |
| Hematology & Oncology Physician | 207RH0003X | D70993 | MD | Primary |
Addresses
Primary practice location
1650 Orleans St
CRB 1 RM 443
Baltimore, MD 21287-0013
Mailing address
PO Box 64474
Baltimore, MD 21264-4474
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036806700 | Medicaid | MD |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57.014085 | OH | MD | Hematology & Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357344000000",
"number": "1629244389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 64474",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212644474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 ORLEANS ST",
"address_2": "CRB 1 RM 443",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212870013",
"telephone_number": "410-614-3977",
"fax_number": "410-614-8160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JENNY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-02",
"last_updated": "2013-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "OH",
"license": "57.014085",
"primary": false
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "MD",
"license": "D70993",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036806700",
"state": "MD"
}
],
"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 Jan 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.