Individual provider Active NPI

Justin Kim, MD

  • Student in an Organized Health Care Education/Training Program
  • Baltimore, MD
National Provider Identifier
1780443432
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
345 Saint Paul St BLDG 7TH
Baltimore, MD 21202-2123
Phone
(410) 332-9694
NPI assigned
Mar 15, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MD Primary

Addresses

Primary practice location

345 Saint Paul St BLDG 7TH
Baltimore, MD 21202-2123

Mailing address

225 N Calvert St Apt 1513
Baltimore, MD 21202-4961
Phone (443) 610-0657

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
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1710460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1780443432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 N CALVERT ST APT 1513",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212024961",
            "telephone_number": "443-610-0657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 SAINT PAUL ST BLDG 7TH",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022123",
            "telephone_number": "410-332-9694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JUSTIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-15",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.