MRS. SUSAN KIM (NPI# 1629466826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629466826 |
| Entity Type | Individual |
| Full Name | MRS. SUSAN KIM |
| Credential | CRNP |
| Practice Address |
1030 Liberty Rd Suite 100 Eldersburg MD 21784-7941 |
| Practice Telephone | 4105490900 |
| Practice Fax Number | 4105496121 |
| Mailing Telephone | 4105490900 |
| Mailing Fax Number | 4105496121 |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2014-12-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
R213300 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339861 | Susan Haesook Kim | Pharmacist | 1400 2nd St, Edmod, Edmond, OK 73034 | 2020-09-01 |
| 1184263634 | Susan Kim | Pharmacist | 14529 28th Dr Se, Mill Creek, WA 98012-5707 | 2020-01-02 |
| 1548780901 | Susan Kim | Marriage & Family Therapist | 12625 High Bluff Dr Ste 103, San Diego, CA 92130-2053 | 2017-06-26 |
| 1013371210 | Susan Kim | Pharmacist | 192 Orchard Park Dr, Apt 287, Davis, CA 95616-5343 | 2016-04-13 |
| 1861893000 | Susan Kim | Dietitian, Registered | 21011 Storrs Rd, Sackets Harbor, NY 13685-3172 | 2014-09-08 |
| 1033559505 | Susan Kim | Counselor | 2900 Eastlake Ave E, Suite 220, Seattle, WA 98102-3012 | 2013-06-28 |
| 1538424080 | Susan Soojin Kim | Specialist | 12 Sterling Pl, 1st Fl, Edgewater, NJ 07020-1415 | 2012-07-11 |
| 1427202456 | Susan Youn Kim | Optometrist | 3184 Queens East St, Eugene, OR 97401-8525 | 2008-11-04 |
| 1184807257 | Susan J. Kim | Physical Medicine & Rehabilitation | 7703 Floyd Curl Dr, Mc7798, San Antonio, TX 78229-3901 | 2007-12-12 |
| 1619019429 | Susan Kim | Acupuncturist | 4950 Wilshire Blvd, Los Angeles, CA 90010-3805 | 2007-02-12 |
| Street Address |
1030 LIBERTY RD SUITE 100 |
| City | ELDERSBURG |
| State | MD |
| Zip Code | 21784-7941 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295714004 | Loretta Ann Schueler | Dentist | 1030 Liberty Rd, Suite 101, Eldersburg, MD 21784-7941 | 2006-01-10 |
| 1568860294 | Liberty Pediatrics, LLC | Clinic/Center | 1030 Liberty Rd, Suite 100, Eldersburg, MD 21784-7941 | 2014-12-11 |
| 1265837785 | Loretta A Schueler, Dds, Inc | Dentist | 1030 Liberty Rd, Suite 101, Eldersburg, MD 21784-7941 | 2014-10-27 |
| 1972803344 | Lori Kropfelder | Clinical Nurse Specialist | 1030 Liberty Rd, Suite 100, Eldersburg, MD 21784-7941 | 2010-11-01 |
| 1457311094 | Liberty Pediatrics, LLC | Pediatrics | 1030 Liberty Rd, Suite 100, Eldersburg, MD 21784-7941 | 2006-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033681085 | Kathleen Busching | Occupational Therapy Assistant | Intergrace Fairhaven, 7200 Third Ave, Sykesville, MD 21784 | 2018-12-31 |
| 1619450376 | Mackenzie Fleming | Counselor | 6220 Georgetown Blvd Suite C, Eldersburg, MD 21784 | 2018-09-10 |
| 1316426919 | Rebecca Rubin | Nurse Practitioner | 1380 Progress Way, Suite 102, Eldersburg, MD 21784 | 2018-08-14 |
| 1417473273 | Andrey Doroshenko | Dentist | 1722 Underwood Road, Sykesville, MD 21784 | 2017-08-14 |
| 1992229694 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 6400 Georgetown Blvd, Eldersburg, MD 21784 | 2017-08-03 |
| 1457894495 | Bethany Six | Nurse Practitioner | 6190 Gerogetown Blvd, Eldersburg, MD 21784 | 2016-11-23 |
| 1982011821 | Fast Track Urgent Care, LLC | Clinic/Center | 1315 Breton Drive, Eldersburg, MD 21784 | 2014-07-11 |
| 1588097984 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 5961 Exchange Dr, Suite 100, Eldersburg, MD 21784 | 2013-08-21 |
| 1356690986 | Kayla Nicole Koster | Speech-Language Pathologist | 1702 Liberty Road, First Floor, Sykesville, MD 21784 | 2012-08-29 |
| 1558645663 | Fusion Dental | Dentist | 5959 Exchange Drive, Suite 116, Eldersburg, MD 21784 | 2011-10-07 |
| Find all providers in zip 21784 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902405574 | Kylie White | Nurse Practitioner | 29595 Millstream Dr, Salisbury, MD 21804-2006 | 2020-10-23 |
| 1437764214 | Kelly Weaver | Nurse Practitioner | 11315 Pembroke Square, 110, Waldorf, MD 20603 | 2020-09-09 |
| 1003420282 | Mary Claire Perry | Nurse Practitioner | 737 W Lombard St Ste 314, Baltimore, MD 21201-1009 | 2020-09-03 |
| 1063022853 | Lauren Ranieri | Nurse Practitioner | 5301 Westbard Cir Ste 3, Bethesda, MD 20816-1463 | 2020-08-06 |
| 1841847209 | Brittany Nichole Frankel | Nurse Practitioner | 5870 Old Washington Rd, Sykesville, MD 21784-8622 | 2019-08-21 |
| 1912553595 | Kelsey Lynn Peifer | Nurse Practitioner | 6131 Baldridge Ter, Frederick, MD 21701-5858 | 2019-08-10 |
| 1841845351 | Advanced Practice Wellness, LLC | Nurse Practitioner | Washingtonian Blvd Ste 550, Gaithersburg, MD 20878 | 2019-08-02 |
| 1851946305 | Monica Patel | Nurse Practitioner | 3450 Old Washington Rd Ste 100, Waldorf, MD 20602-3249 | 2019-08-01 |
| 1922651082 | Deborah A Weber | Nurse Practitioner | 480 Lake Dr, Lusby, MD 20657-3260 | 2019-07-18 |
| 1700438140 | Emily Megan Burke | Nurse Practitioner | 200 Forbes St Annapolis, Md 21401, Suite 200, Annapolis, MD 21401 | 2019-07-16 |
| Find all providers with the same taxonomy | ||||
| City | ELDERSBURG |
| Zip Code | 21784 |
Please comment or provide details below to improve the information on MRS. SUSAN 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.