Jeung Hyoun Kim, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT003063 Issued in GA

Practice address

29 Dawson Village Way S
Dawsonville, GA 30534-5632

Phone

(706) 216-7732

Fax

(706) 216-0168

NPI assigned

May 9, 2011

Last updated

Sep 22, 2020By the provider in NPPES

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of California - School of Optometry, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Connell and Kim, O.D. Associates Limited Liability CompanyGroup PAC ID 3577983006, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Connell and Kim, O.D. Associates Limited Liability Company

  dba Spec-Takular Boutique

  • Optometrist
  • Dawsonville, GA
  • NPI 1881212710
  Medicare reassignment Care Compare group NPD
• Suzanne Kimmons, OD, PC

  • Eyewear Supplier
  • Dawsonville, GA
  • NPI 1013196377
  NPD (past)

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

{
    "created_epoch": "1304899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1205128360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 DAWSON VILLAGE WAY S",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305345632",
            "telephone_number": "706-216-7732",
            "fax_number": "706-216-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 DAWSON VILLAGE WAY S",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305345632",
            "telephone_number": "706-216-7732",
            "fax_number": "706-216-0168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JEUNG",
        "middle_name": "HYOUN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-09",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Autumn Lee Keller, ATC, LAT
• Jacob Isaac Kelly, PT, DPT
• Michael Kenney, LCSW
• Jessica Kersey
• Eugene Affum Keteku
• Seung Yun Kim, MD
• Suzanne Kimmons-Doty, OD
• Robert C King, LCSW
• Anna Katherine Kinley, MSN, APRN, CPNP
• Molly Magdalene Kirk

• Optometrist in Dawsonville, GA
• Providers in Dawsonville, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; 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.
• 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.