DR. LISA M KIM (NPI# 1982795753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982795753 |
| Entity Type | Individual |
| Full Name | DR. LISA M KIM |
| Credential | M.D. |
| Practice Address |
3355 Rogers Ave Ellicott City MD 21043-4105 |
| Practice Telephone | 4104805195 |
| Practice Fax Number | 4104805197 |
| Mailing Telephone | 4104805195 |
| Mailing Fax Number | 4104805197 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | D0052479 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | TAX ID | 141887661 | 01 |
| MD | DEA NUMBER | BK5584734 | 01 |
| MD | 346603500 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235752569 | Lisa Ann Kim | Occupational Therapist | 13562 Purdy St, Garden Grove, CA 92844-2522 | 2020-05-20 |
| 1700288305 | Lisa Young Kim | Pharmacist | 2100 Valencia Dr Apt 305, Northbrook, IL 60062-7088 | 2014-09-25 |
| 1942341250 | Lisa Sunhee Kim | Internal Medicine | 2604 Dempster St Ste 300, Park Ridge, IL 60068-8427 | 2007-02-09 |
| 1811061674 | Lisa R Kim | Dentist | 241 S Beverly Dr, Beverly Hills, CA 90212-3807 | 2006-11-20 |
| 1154969160 | Lisa Kim | Developmental Therapist | 321 Fortune Blvd, Milford, MA 01757-1750 | 2019-12-20 |
| 1093276842 | Lisa Kim | Student in an Organized Health Care Education/Training Program | 395 W 12th Ave Fl 3, Columbus, OH 43210-1267 | 2019-03-26 |
| 1972087773 | Lisa Jisun Kim | Student in an Organized Health Care Education/Training Program | 240 E Huron St Ste 1-200, Chicago, IL 60611-2909 | 2018-09-18 |
| 1548754385 | Lisa Jiyoung Kim | Nurse Practitioner | 830 Harrison Ave, Moakley, 3rd Floor, Boston, MA 02118 | 2018-06-15 |
| 1427577931 | Lisa Kim | Pharmacist | 13000 Indian School Rd Ne, Albuquerque, NM 87112-4803 | 2017-09-15 |
| 1063818565 | Lisa Kim | Counselor | 3800 Coolidge Ave, Oakland, CA 94602-3311 | 2014-11-10 |
| Street Address |
3355 ROGERS AVE |
| City | ELLICOTT CITY |
| State | MD |
| Zip Code | 21043-4105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457660110 | Lisa M Kim M D Inc | Clinic/Center | 3355 Rogers Ave, Ellicott City, MD 21043-4105 | 2010-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982242764 | Joyce Melinda Kelly | Social Worker | 8181 Main Street, 2nd Floor, Ellicott City, MD 21043 | 2019-12-12 |
| 1437703972 | Capitol Health Care, LLC | Speech-Language Pathologist | 4115 Sears House Court, Ellicott City, MD 21043 | 2019-08-01 |
| 1851857429 | Carol Ann Mckissick | Counselor | 2850 N. Ridge Rd. Suite 208a, Santoro Psychological Services, Ellicott City, MD 21043 | 2019-02-19 |
| 1659877017 | Tender Touch Healthcare Services LLC | In Home Supportive Care | 8960 Town and Country Blvd, Apt F, Ellicott, MD 21043 | 2018-04-04 |
| 1912426099 | Hf & Associates, LLC | Community/Behavioral Health | 3565 C2 Ellicott Mills Drive, Suite 202, Ellicott City, MD 21043 | 2017-09-11 |
| 1134666779 | Stephanie Jean | Behavioral Analyst | 8762 Town and Country Blvd, Ellicott City, MD 21043 | 2017-01-20 |
| 1124574744 | I Can't We Can Counseling Center | Preferred Provider Organization | 7060 O(akland Mills Rd, Columbia, MD 21043 | 2016-09-01 |
| 1598139925 | Jun Woo Lee | Chiropractor | 8492 Baltimore National Pike Suite 105, Ellicott City, MD 21043 | 2015-11-23 |
| 1518338953 | Byron Lam | Chiropractor | 2850 N Ridge Rd Ste 107a, Ellicott City, MD 21043 | 2015-10-12 |
| 1942682174 | Jea Sub Song | Chiropractor | 3460 Ellicott Center Dr Ste 102, Ellicott City, MD 21043 | 2015-06-24 |
| Find all providers in zip 21043 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861857484 | Columbia Medics Inc | Internal Medicine | 10615 Old Ellicott Cir, Ellicott City, MD 21042-2199 | 2015-12-25 |
| 1588088579 | Sarah K Varghese I | Internal Medicine | 12245 Frederick Rd, Ellicott City, MD 21042-1050 | 2014-02-11 |
| 1417254947 | Barbara Pearson Wasserman | Internal Medicine | 13200 Triadelphia Rd, Ellicott City, MD 21042-1143 | 2011-02-18 |
| 1275841595 | Goda P Damera | Internal Medicine | 3128 Wheaton Way, Apt E, Ellicott City, MD 21043 | 2010-09-21 |
| 1205091055 | Karithanom V Isaac | Internal Medicine | 3205 Robin Hood Ct, Ellicott City, MD 21042 | 2008-07-22 |
| 1033373378 | Jeffrey R. Kaplan M.d. LLC | Internal Medicine | 5116 Dorsey Hall Dr Ste A, Ellicott City, MD 21042-7877 | 2008-07-16 |
| 1316013535 | Musadag Mamoun Sinada | Internal Medicine | Care of M Sinada 3317 Hobble Court, Ellicott City, MD 21043-3319 | 2006-11-28 |
| 1891871109 | Charles Edward Sheehan IIi | Internal Medicine | 2850 N Ridge Rd Ste 103, Ellicott City, MD 21043 | 2006-10-29 |
| 1396833604 | Mitul N Dave | Internal Medicine | 9055 Chevrolet Drive, Suite 103, Ellicott City, MD 21042 | 2006-10-11 |
| 1437195682 | Jagdeep Singh | Internal Medicine | 5070 Winesap Way, Ellicott City, MD 21043-7184 | 2006-06-22 |
| Find all providers in ELLICOTT CITY | ||||
| City | ELLICOTT CITY |
| Zip Code | 21043 |
Please comment or provide details below to improve the information on DR. LISA M KIM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.