Jiye Kwon Kim

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

93583 Issued in GA

Practice address

4700 Waters Ave
Savannah, GA 31404-6220

Phone

(912) 350-7573

NPI assigned

Mar 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Mercer University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Georgia Clinic, PCGroup PAC ID 8426949587, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medside Home Health Agency Home health agency, Sandy Springs, GA, CCN 117126

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Georgia Clinic, PC

  • Multi-Specialty Clinic/Center
  • Dunwoody, GA
  • NPI 1609816123
  Medicare reassignment Care Compare group NPD
• Cogent Healthcare of Georgia PC

  • Internal Medicine Physician
  • Macon, GA
  • NPI 1609827823
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Medside Corporation

  • Home Health Agency
  • Sandy Springs, GA
  • NPI 1306858121
  Care Compare affiliation

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1043770928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 E 48TH ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314052341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046220",
            "telephone_number": "912-350-7573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON KIM",
        "first_name": "JIYE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "93583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anand Raj Kumar, M.D.
• Dana A Kumjian, MD
• Pathya Kunthy, DO, MPH
• Yulianty D. Kusuma, MD
• KWK Freight Enterprise
• Cholponai Kydyralieva
• Peri Kyriacos, LCSW
• L. Rochelle Ainsworth, LLC
• Marcia L'Hommedieu, L.AC
• Lab Lady Diagnostics, LLC

• Internal Medicine Physician in Savannah, GA
• Providers in Savannah, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.