Mi Jin Kim

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

Practice address

44980 Hamptons Blvd Apt 213
Leonardtown, MD 20650-4752

Phone

(703) 678-9161

NPI assigned

Sep 24, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1632441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1679244149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44980 HAMPTONS BLVD APT 213",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206504752",
            "telephone_number": "703-678-9161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44980 HAMPTONS BLVD APT 213",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206504752",
            "telephone_number": "703-678-9161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MI",
        "middle_name": "JIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-24",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "MD",
            "license": "09361",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Navjeet Kaur
• Alice Lillybeth Kelly
• Sanjar Khodjaev, DMD
• Kidney Care Center Southern Maryland LLC
• Cynthia J Kilcoyne
• Robert Konkol, M.D.
• Crystal Koran, SLP
• Diana Lynne Kraft, LCPC
• Rakhi Krishnan
• Ernestine Lakner, PA-C

• Physical Rehabilitation Occupational Therapist in Leonardtown, MD
• Providers in Leonardtown, MD by specialty
• Physical Rehabilitation Occupational Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.