Individual provider Active NPI

Jennifer Un-Jin Kang, FNP-C

  • Family Nurse Practitioner
  • Cumming, GA
National Provider Identifier
1205353422
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP214028 Issued in GA
Practice address
980 Sanders Rd Ste 100
Cumming, GA 30041-5977
Phone
(770) 886-1074
NPI assigned
Aug 28, 2017
Last updated
Nov 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP214028 GA Primary

Addresses

Primary practice location

980 Sanders Rd Ste 100
Cumming, GA 30041-5977

Mailing address

3390 Kiveton CT
Peachtree Corners, GA 30092-3375
Phone (770) 686-1780

Other practice location 1

3637 Peachtree Rd NE
Atlanta, GA 30319-1252
Phone (404) 926-3541

Other practice location 2

4040 Old Milton Pkwy Ste 200
Alpharetta, GA 30005-3428
Phone (770) 771-5270

Other practice location 3

6300 Hospital Pkwy Ste 375
Johns Creek, GA 30097-2461
Phone (770) 771-5260

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180611002701 GA Practitioner - Nurse Practitioner 9830444017 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gwinnett Physician Group, LLCGroup PAC ID 9133211139, 112 clinicians

Practice addresses (Care Compare)

1000 Medical Ctr Blvd
Lawrenceville, GA 30046-7694
Phone (678) 312-4321

1200 Northside Forsyth Dr
Cumming, GA 30041-7659
Phone (770) 844-3200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NP214028GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Primary Care Professional Services, LLC CurrentSince Apr 15, 2021 Accepting new patients
North Atlanta Professional Services LLC CurrentSince May 25, 2025 Accepting new patients
Gwinnett Physician Group, LLC CurrentSince Mar 28, 2022 Accepting new patients
Northside Primary Care Professional Services,LLC CurrentSince Apr 15, 2021 Accepting new patients
North Atlanta Women's Care, PC Past Accepting new patients
North Atlanta Vascular Clinic, PC Past Accepting new patients
Gwinnett Medical Group, Inc Past Accepting new patients

Locations

1200 Northside Forsyth Dr
Cumming, GA 30041
Phone (770) 292-4806

81 Northside Dawson Dr
Ste 305
Dawsonville, GA 30534
Phone (770) 754-0789

3620 Howell Ferry Rd
Duluth, GA 30096
Phone (678) 312-3294

1132 Athens Hwy
Ste 207
Grayson, GA 30017
Phone (678) 312-0300

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EHIJAA

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1205353422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 KIVETON CT",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300923375",
            "telephone_number": "770-686-1780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 SANDERS RD STE 100",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300415977",
            "telephone_number": "770-886-1074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3637 Peachtree Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303191252",
            "country_code": "US",
            "telephone_number": "404-926-3541",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4040 Old Milton Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300053428",
            "country_code": "US",
            "telephone_number": "770-771-5270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6300 Hospital Pkwy Ste 375",
            "address_purpose": "LOCATION",
            "city": "Johns Creek",
            "state": "GA",
            "postal_code": "300972461",
            "country_code": "US",
            "telephone_number": "770-771-5260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANG",
        "first_name": "JENNIFER",
        "middle_name": "UN-JIN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-28",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "NP214028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.