Jacqueline Lim, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1005 Dr DB Todd Jr Blvd
Nashville, TN 37208-3501

Phone

(615) 327-6350

Fax

(615) 327-6260

NPI assigned

Apr 1, 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

Enrolled in TX

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

Specialty

Psychiatry

Education

University of the Incarnate Word School of Osteo Medicine, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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.

• Harmonyville PLLC

  • Child & Adolescent Psychiatry Physician
  • McKinney, TX
  • NPI 1023962636
  Medicare reassignment

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717891200000",
    "number": "1730767492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 DR DB TODD JR BLVD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372083501",
            "telephone_number": "615-327-6350",
            "fax_number": "615-327-6260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Main St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761044917",
            "country_code": "US",
            "telephone_number": "817-702-3100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIM",
        "first_name": "JACQUELINE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-01",
        "last_updated": "2024-06-09",
        "certification_date": "2024-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "V0795",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lilly Haven Care Services LLC
• Dustin J. Lilly, PA-C
• Kathryn M Lilly, APRN
• Heang Henry Lim, PHARMD
• Hyun-Joo Lim, D.D.S.
• Noel P Lim, MD
• Rene Michael Lim, MD
• Sue Lim
• Brian Lima, M.D.
• Jose Gabriel Lima, MD

• Student in an Organized Health Care Education/Training Program in Nashville, TN
• Providers in Nashville, TN by specialty
• Student in an Organized Health Care Education/Training Program in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.