MR. JAE HOON KIM CRNP-PMH NPI 1760726525

NPI Information

NPI: 1760726525
Provider Name: MR. JAE HOON KIM, CRNP-PMH
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
7201 WISCONSIN AVE STE 440
BETHESDA, MD
ZIP 20814
Phone: (202) 236-4669
Get Directions

MR. Jae Hoon Kim, CRNP-PMH is a psychiatric/mental health nurse practitioner in Bethesda, MD with 12 years of experience. MR. Jae Hoon Kim, CRNP-PMH NPI is 1760726525. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7201 WISCONSIN AVE STE 440
BETHESDA, MD
ZIP 20814-851
Phone: (202) 236-4669

The NPI 1760726525 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/19/2012 and was last updated on 8/19/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	0024178821	VIRGINIA	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	R189134	MARYLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	587108500	MEDICAID	MARYLAND
2	822275	MEDICAID	MARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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