Ag Family Medicine, PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

59806 Issued in GA

Legal business name

AG FAMILY MEDICINE, PC

Practice address

3590 Peachtree Industrial Blvd
Duluth, GA 30096-4817

Phone

(770) 614-9799

Fax

(770) 614-9789

NPI assigned

Jun 11, 2008

Last updated

Dec 15, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Chang Soo KimNPI 1215149554

Title

President

Phone

(770) 614-9799

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chang Soo Kim, MD

  • Family Medicine Physician
  • Duluth, GA
  • NPI 1215149554
  Medicare reassignment NPD Authorized official
• Wonjin Rhi, NP-C

  • Family Nurse Practitioner
  • Duluth, GA
  • NPI 1205488277
  Medicare reassignment NPD
• Eunji An Sung, NP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Suwanee, GA
  • NPI 1821455783
  Medicare reassignment NPD
• Young D Kim, APRN

  • Family Nurse Practitioner
  • Duluth, GA
  • NPI 1144046889
  NPD

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765756800000",
    "number": "1174783435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3590 PEACHTREE INDUSTRIAL BLVD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964817",
            "telephone_number": "770-614-9799",
            "fax_number": "770-614-9789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3590 PEACHTREE INDUSTRIAL BLVD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964817",
            "telephone_number": "770-614-9799",
            "fax_number": "770-614-9789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AG FAMILY MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-11",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "CHANG SOO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-614-9799"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "59806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "868452174A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Duluth, GA
• Providers in Duluth, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.