Organization Active NPI

Mesun Health Services, Inc

  • Skilled Nursing Facility
  • Lawrenceville, GA
National Provider Identifier
1215550264
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MESUN HEALTH SERVICES, INC
Practice address
88 Johnson Rd. Building #2
Lawrenceville, GA 30046
Phone
(404) 369-1907
Fax
(404) 369-1970
NPI assigned
May 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2020

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

Authorized official

Name
Mr. Eugene T Kim, M.DNPI 1538456843
Title
Ceo
Phone
(919) 599-8107

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

88 Johnson Rd. Building #2
Lawrenceville, GA 30046

Mailing address

88 Johnson Rd. Building #2
Lawrenceville, GA 30046
Phone (404) 369-1907

Other names 1

  • MeSun Health & Rehabilitation Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20201228001750 GA Part A Provider - Skilled Nursing Facility 9739190869 Practice locations: Lawrenceville, GA
O20210319001443 GA Part B Supplier - Clinic/Group Practice 9739190869 Receives reassigned benefits from 1 practitioner
Practice locations: Lawrenceville, GA

Skilled nursing facility certification: CCN 115772

Legal name
MESUN HEALTH SERVICES INC
Doing business as
MESUN HEALTH AND REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 6, 2021
Last certification
Jul 18, 2024
Beds
100
Ownership / control type
Individual
Organization structure
CorporationProprietary
Enrollment address
88 Johnson Rd
BLDG 2
Lawrenceville, GA 30046-5520
Nursing home name
MESUN HEALTH AND REHABILITATION CENTER

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Mesun Health and Rehabilitation CenterCCN 115772
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Individual
Certified
Jan 6, 2021
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10070.3 residents per day on average
Penalties (3 years)
2Fines totaling $4,017

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Eugene T Kim Individual 5% Or Greater Direct Ownership Interest Mar 28, 2022 100%
Danny Cotton Individual Corporate OfficerCfo Aug 20, 2020
W-2 Managing EmployeeCfo Aug 21, 2020
Hanson Kim Individual 5% Or Greater Direct Ownership Interest Aug 20, 2020 100%
Corporate OfficerCeo Aug 20, 2020 100%
Sukhee Seol Individual Corporate OfficerCoo Aug 22, 2020
W-2 Managing EmployeeCoo Aug 22, 2020
Bruce Radman Individual W-2 Managing EmployeeAdministrator Aug 22, 2020
Operational/Managerial ControlAdministrator Aug 22, 2020

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590451200000",
    "number": "1215550264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 JOHNSON RD. BUILDING #2",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30046",
            "telephone_number": "404-369-1907",
            "fax_number": "404-369-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 JOHNSON RD. BUILDING #2",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30046",
            "telephone_number": "404-369-1907",
            "fax_number": "404-369-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESUN HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-26",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-599-8107",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MeSun Health & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.