Individual provider Active NPI

Joseph Kim, APRN, FNP-C

  • Family Nurse Practitioner
  • Suwanee, GA
National Provider Identifier
1033898499
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN319919 Issued in GA
Practice address
2685 Peachtree Pkwy
Suwanee, GA 30024-5646
Phone
(770) 771-5260
NPI assigned
Jul 13, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN319919 GA Primary

Addresses

Primary practice location

2685 Peachtree Pkwy
Suwanee, GA 30024-5646

Mailing address

259 Privet Cir
Suwanee, GA 30024-7447
Phone (505) 331-6509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231218001938 GA Practitioner - Nurse Practitioner 6709235658 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN319919GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Atlanta Vascular Clinic, PC CurrentSince Nov 29, 2023 Accepting new patients

Locations

2685 Peachtree Pkwy
Suwanee, GA 30024
Phone (770) 771-5260

2685 Peachtree Pkwy
Ste 320
Suwanee, GA 30024
Phone (770) 771-5260

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EHIJAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/AAFJBD/Endpoint/AAFJBD

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1689206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1033898499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 PRIVET CIR",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300247447",
            "telephone_number": "505-331-6509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2685 PEACHTREE PKWY",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300245646",
            "telephone_number": "770-771-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOSEPH",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-13",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN319919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.