Yejin Kim, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

057711 Issued in GA

Practice address

3435 Duluth Park LN
Suite a
Duluth, GA 30096-3259

Phone

(678) 417-0407

Fax

(678) 417-2008

NPI assigned

Dec 14, 2006

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: ykim8194@choa.gadirect.net

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.

• GC Duluth Pediatrics, Inc.

  • Pediatrics Physician
  • Duluth, GA
  • NPI 1922374297
  NPD (past)

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114089596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 DULUTH PARK LN",
            "address_2": "SUITE A",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300963259",
            "telephone_number": "678-417-0407",
            "fax_number": "678-417-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 DULUTH PARK LN",
            "address_2": "SUITE A",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300963259",
            "telephone_number": "678-417-0407",
            "fax_number": "678-417-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YEJIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "057711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Soo Kim
• Sook J Kim, D.D.S.
• Sue Lee Kim, CNP
• Sun Chun Kim, DDS
• Sung H Kim
• Yongdong Kim, PHARM D
• Young D Kim, APRN
• Young-Tae Kim
• Kim'S Acupuncture and Chiropractic
• Kim'S Eyeland Optical, Inc.

• Pediatrics Physician in Duluth, GA
• Providers in Duluth, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.