Active NPI
James Hankil Kim, MD
- Psychiatry Physician
- Lawrenceville, GA
National Provider Identifier
1073140265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 326554
- Practice address
- 455 Philip Blvd
Lawrenceville, GA 30046-8767 - Phone
- (404) 329-2222
- NPI assigned
- Mar 26, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | 326554 | NY | Primary |
Addresses
Primary practice location
455 Philip Blvd
Lawrenceville, GA 30046-8767
Mailing address
Building 52/Lake Drive
Mountain Home, TN 37684
Phone (423) 439-8000
Other practice location 1
Building 52/Lake Drive
Mountain Home, TN 37684
Phone (423) 439-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 326554 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718496000000",
"number": "1073140265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BUILDING 52/LAKE DRIVE",
"city": "MOUNTAIN HOME",
"state": "TN",
"postal_code": "37684",
"telephone_number": "423-439-8000",
"fax_number": "423-439-2200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 PHILIP BLVD",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300468767",
"telephone_number": "404-329-2222"
}
],
"practiceLocations": [
{
"address_1": "Building 52/Lake Drive",
"address_purpose": "LOCATION",
"city": "Mountain Home",
"state": "TN",
"postal_code": "37684",
"country_code": "US",
"telephone_number": "423-439-8000",
"fax_number": "423-439-2200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "JAMES",
"middle_name": "HANKIL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-26",
"last_updated": "2024-06-16",
"certification_date": "2024-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "326554",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.