Jiyeon Kim, PA

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F0317639 Issued in GA

Practice address

3610 Peachtree Industrial Blvd
Suite 100
Duluth, GA 30096-4953

Phone

(678) 417-0332

Fax

(470) 200-2823

NPI assigned

Nov 16, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jkim294399@direct.ochin.org

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.

• Woun Hue Seok DO PC

  • Family Medicine Physician
  • Duluth, GA
  • NPI 1821286956
  NPD (past)

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

{
    "created_epoch": "1479254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1154863520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 PEACHTREE INDUSTRIAL BLVD",
            "address_2": "SUITE 100",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964953",
            "telephone_number": "678-417-0332",
            "fax_number": "470-200-2823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 PEACHTREE INDUSTRIAL BLVD",
            "address_2": "SUITE 100",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964953",
            "telephone_number": "678-417-0332",
            "fax_number": "470-200-2823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JIYEON",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-16",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "F0317639",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "F0317639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hyun Bok Kim, DDS
• Hyunjung Kim
• Ji a Kim
• Jin Dea Kim, M.D.
• Jina Y. Kim, MD
• Jo Myeong Kim, DO
• John Minsung Kim, DACM, L.AC., DIPL.AC
• Jong-Hyun Kim, M.D.
• Joseph Kim, D.D.S., D.C.
• Joshua Kim, D.D.S.

• Family Nurse Practitioner in Duluth, GA
• Providers in Duluth, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; 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.