Individual provider Active NPI

Evelyn Lana Kim

  • Pharmacist
  • Washington, DC
National Provider Identifier
1750856423
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
21001 Issued in MD
Practice address
4500 Wisconsin Ave NW
Washington, DC 20016-4628
Phone
(202) 244-1206
NPI assigned
Oct 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202210579 VA
Pharmacist 183500000X 21001 MD Primary

Addresses

Primary practice location

4500 Wisconsin Ave NW
Washington, DC 20016-4628

Mailing address

4500 Wisconsin Ave NW
Washington, DC 20016-4628
Phone (202) 244-1206

Other practice location 1

5115 Leesburg Pike
Falls Church, VA 22041-3207
Phone (703) 253-0022

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

LicenseStateTypeSpecialty
21001MDMDPharmacist
0202210579VAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1750856423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 WISCONSIN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200164628",
            "telephone_number": "202-244-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 WISCONSIN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200164628",
            "telephone_number": "202-244-1206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5115 Leesburg Pike",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220413207",
            "country_code": "US",
            "telephone_number": "703-253-0022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "EVELYN",
        "middle_name": "LANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202210579",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "21001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.