Individual provider Active NPI

Sophia Kim, MD

  • Pediatric Pulmonology Physician
  • Atlanta, GA
National Provider Identifier
1184744690
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
62535 Issued in GA
Practice address
859 Mount Vernon Hwy NE Ste 300
Atlanta, GA 30328-4255
Phone
(404) 785-0588
Fax
(404) 785-0596
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 62535 GA Primary

Addresses

Primary practice location

859 Mount Vernon Hwy NE Ste 300
Atlanta, GA 30328-4255

Mailing address

859 Mount Vernon Hwy NE Ste 300
Atlanta, GA 30328-4255
Phone (404) 785-0588

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address choa@choa.gadirect.net

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
I20190130000962 GA Order and Referring Only - Pulmonary DiseasePractitioner - Pulmonary Disease 9032255203

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62535GAMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scottish Rite Childrens Medical Ctr Past Accepting new patients
Scottish Rite Children'S Medical Center Past Accepting new patients
Choa Multispecialty, LLC Pediatrics PastSince Jun 27, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: skim39847@choa.gadirect.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1184744690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "859 MOUNT VERNON HWY NE STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284255",
            "telephone_number": "404-785-0588",
            "fax_number": "404-785-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 MOUNT VERNON HWY NE STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284255",
            "telephone_number": "404-785-0588",
            "fax_number": "404-785-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SOPHIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "GA",
            "license": "62535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "859 Mount Vernon Hwy NE Ste 300",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303284255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.