Individual provider Active NPI

Kent C Choi, MD

  • Surgery Physician
  • Iowa City, IA
National Provider Identifier
1184618456
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
87331 Issued in GA
Practice address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone
(319) 356-7892
Fax
(319) 356-3392
NPI assigned
Sep 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 34262 IA
Surgery Physician 208600000X 87331 GA Primary

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1009

Mailing address

55 Whitcher St NE Ste 130
Marietta, GA 30060-1156
Phone (770) 428-0462

Other practice location 1

55 Whitcher St NE Ste 130
Marietta, GA 30060-1156
Phone (770) 428-0462

Other identifiers 2

IdentifierTypeStateIssuer
41988OtherIAWELLMARK BCBS
0246512MedicaidIA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kchoi391461@directwellstar.org

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201221002734 GA Practitioner - General Surgery 5991724833 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Georgia School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (470) 852-2301

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34262IAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Affiliates of California Surgery CurrentSince Feb 1, 2026 Accepting new patients

Locations

355 Clear Creek Pkwy
Ste 1004
Lavonia, GA 30553
Phone (706) 356-0780

367 Clear Creek Pkwy
Lavonia, GA 30553
Phone (706) 356-7800

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1184618456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE STE 130",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601156",
            "telephone_number": "770-428-0462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-7892",
            "fax_number": "319-356-3392"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Whitcher St NE Ste 130",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300601156",
            "country_code": "US",
            "telephone_number": "770-428-0462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHOI",
        "first_name": "KENT",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "34262",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "87331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "41988",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0246512",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kchoi391461@directwellstar.org",
            "affiliation": "N",
            "address_1": "55 Whitcher St NE Ste 130",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300601156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.