Individual provider Active NPI

Hannah Kim, AU.D., CCC-A

  • Audiologist
  • Reston, VA
National Provider Identifier
1811276991
Registry record updated Aug 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2201001470 Issued in VA
Practice address
1860 Town Center Dr
#335
Reston, VA 20190-5896
Phone
(703) 787-3322
NPI assigned
Aug 8, 2011
Last updated
Aug 8, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2201001470 VA Primary

Addresses

Primary practice location

1860 Town Center Dr
#335
Reston, VA 20190-5896

Mailing address

12028 Starboard Dr
#403
Reston, VA 20194-4319
Phone (703) 787-3322

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2201001470VAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Reston Ear Nose and Throat PC CurrentSince Aug 1, 2011 Accepting new patients
Edwin J Lee MD PC PastSince Aug 1, 2011 Accepting new patients

Locations

1860 Town Center Dr
Ste 335
Reston, VA 20190
Phone (703) 787-3322

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312761600000",
    "number": "1811276991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12028 STARBOARD DR",
            "address_2": "#403",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201944319",
            "telephone_number": "703-787-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 TOWN CENTER DR",
            "address_2": "#335",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905896",
            "telephone_number": "703-787-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HANNAH",
        "name_prefix": "Dr.",
        "credential": "AU.D., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-08",
        "last_updated": "2011-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201001470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2011; 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.