Healthcare Provider Details

I. General information

NPI: 1922918200
Provider Name (Legal Business Name): JOHN KAIM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 E BROAD ST # 90
FUQUAY VARINA NC
27526-1968
US

IV. Provider business mailing address

409 ARBORHILL LN
HOLLY SPRINGS NC
27540-6210
US

V. Phone/Fax

Practice location:
  • Phone: 855-832-6727
  • Fax:
Mailing address:
  • Phone: 919-744-9215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: