Active NPI
Kim Jones-Fearing M.D. LLC
- Psychiatry Physician
- Ellicott City, MD
National Provider Identifier
1669447991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- D46124
- Legal business name
- KIM JONES-FEARING M.D. LLC
- Practice address
- 11221 Kinsale CT
Ellicott City, MD 21042-6131 - Phone
- (410) 419-3769
- NPI assigned
- Feb 21, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kim Jones-Fearing, M.D.
- Title
- Medical Director
- Phone
- (301) 421-9112
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | D46124 | MD | Primary |
Addresses
Primary practice location
11221 Kinsale CT
Ellicott City, MD 21042-6131
Mailing address
11221 Kinsale CT
Ellicott City, MD 21042-6131
Phone (410) 419-3769
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 655605 | Other | MD | UNITED HEALTHCARE |
| 413271800 | Medicaid | MD | |
| 23320001 | Other | DC | BC DC/METRO |
| 65FCKB | Other | MD | BC MD |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatry Physician
- Ellicott City, MD
- NPI 1871521393
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140480000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1716249600000",
"number": "1669447991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11221 KINSALE CT",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210426131",
"telephone_number": "410-419-3769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11221 KINSALE CT",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210426131",
"telephone_number": "410-419-3769"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KIM JONES-FEARING M.D. LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-21",
"last_updated": "2024-05-21",
"certification_date": "2024-05-21",
"status": "A",
"authorized_official_last_name": "JONES-FEARING",
"authorized_official_first_name": "KIM",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "301-421-9112",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MD",
"license": "D46124",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "655605",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "413271800",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC DC/METRO",
"identifier": "23320001",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC MD",
"identifier": "65FCKB",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ellicott City, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.