Individual provider Active NPI

Nancy Carol Kim, MD

  • Pediatrics Physician
  • Arlington, VA
National Provider Identifier
1699873307
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
156444 Issued in FL
Practice address
1635 N George Mason Dr Ste 185
Arlington, VA 22205-3633
Phone
(703) 522-7300
Fax
(703) 522-0495
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101053952 VA
Pediatrics Physician 208000000X 156444 FL Primary

Addresses

Primary practice location

1635 N George Mason Dr Ste 185
Arlington, VA 22205-3633

Mailing address

1635 N George Mason Dr Ste 185
Arlington, VA 22205-3633
Phone (703) 522-7300

Other practice location 1

1715 North George Mason Dr
#205
Arlington, VA 22205
Phone (703) 522-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221209000103 FL Practitioner - Pediatric Medicine 6800265059 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
156444FLMDPediatrics Physician
0101053952VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centerplace Health, Inc CurrentSince Aug 31, 2022 Accepting new patients
Pediatrics of Arlington, PLC Pediatrics Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1750 17th St
Ste E
Sarasota, FL 34234
Phone (941) 529-0200

1750 17th St
Ste N
Sarasota, FL 34234
Phone (941) 529-0200

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1699873307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 N GEORGE MASON DR STE 185",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222053633",
            "telephone_number": "703-522-7300",
            "fax_number": "703-522-0495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 N GEORGE MASON DR STE 185",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222053633",
            "telephone_number": "703-522-7300",
            "fax_number": "703-522-0495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1715 North George Mason Dr",
            "address_2": "#205",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "22205",
            "country_code": "US",
            "telephone_number": "703-522-7300",
            "fax_number": "703-522-0495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "NANCY",
        "middle_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101053952",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "156444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, VA

Sources for this page

Verify at the official NPI Registry.