Individual provider Active NPI

Haeun Kim, NP

  • Gerontology Nurse Practitioner
  • Fairfax, VA
National Provider Identifier
1780354290
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
0024180527 Issued in VA
Practice address
3022 Williams Dr Ste 300
Fairfax, VA 22031-4600
Phone
(703) 573-9800
Fax
(703) 738-5720
NPI assigned
Sep 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 0024180527 VA Primary

Addresses

Primary practice location

3022 Williams Dr Ste 300
Fairfax, VA 22031-4600

Mailing address

PO Box 37189
Baltimore, MD 21297-3189
Phone (571) 423-5699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230627000158 DC Practitioner - Nurse Practitioner 0244698090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inova Physician Partners LLCGroup PAC ID 2466581772, 258 clinicians

Practice addresses (Care Compare)

3022 Williams Dr
300 Gimg Fairfax
Fairfax, VA 22031-4600
Phone (703) 573-9800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.98 of 100Reported as apm
Quality
87.97
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Physician Partners, LLC CurrentSince May 1, 2023 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Inova Physician Partners, Inc. - Specialists Past Accepting new patients
Manassas Primary Care, LLC PastSince Sep 1, 2021 Accepting new patients
Dr Arun K Gupta PC PastSince Sep 1, 2021 Accepting new patients

Locations

3833 Fairfax Dr
Ste 200
Arlington, VA 22203
Phone (703) 525-8863

3914 Centreville Rd
Ste 250
Chantilly, VA 20151
Phone (703) 435-1223

3022 Williams Dr
Ste 300
Fairfax, VA 22031
Phone (703) 573-9800

Interoperability endpoints

  • Direct secure messaging: hkim1154964@soc.inova.org

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1780354290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37189",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973189",
            "telephone_number": "571-423-5699",
            "fax_number": "571-423-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3022 WILLIAMS DR STE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314600",
            "telephone_number": "703-573-9800",
            "fax_number": "703-738-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HAEUN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024180527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.