Active NPI
Kim Allen
- Community Health Worker
- Rockville, MD
National Provider Identifier
1720967771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 02274-25-A
- Practice address
- 713 Grand Champion Dr Ste A1
Rockville, MD 20850-5798 - Phone
- (240) 229-8218
- NPI assigned
- Sep 2, 2025
- Last updated
- Sep 2, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 02274-25-A | MD | Primary |
Addresses
Primary practice location
713 Grand Champion Dr Ste A1
Rockville, MD 20850-5798
Mailing address
713 Grand Champion Dr Ste A1
Rockville, MD 20850-5798
Phone (240) 229-8218
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 |
|---|---|---|---|
| 02274-25-A | MD | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756771200000",
"number": "1720967771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "713 GRAND CHAMPION DR STE A1",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208505798",
"telephone_number": "240-229-8218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "713 GRAND CHAMPION DR STE A1",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208505798",
"telephone_number": "240-229-8218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "KIM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-09-02",
"last_updated": "2025-09-02",
"certification_date": "2025-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "MD",
"license": "02274-25-A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.