Individual provider Active NPI

Pyung Gang Cho, LAC

  • Acupuncturist
  • Johns Creek, GA
National Provider Identifier
1235770744
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
516 Issued in GA
Practice address
11180 State Bridge Rd Ste 205
Johns Creek, GA 30022-7483
Phone
(770) 703-9939
NPI assigned
Oct 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 006560 NY
Acupuncturist 171100000X 516 GA Primary

Addresses

Primary practice location

11180 State Bridge Rd Ste 205
Johns Creek, GA 30022-7483

Mailing address

5192 Lower Creek St
Peachtree Corners, GA 30092-2395
Phone (347) 331-7237

Other practice location 1

2915 Professional Pkwy Ste D
Augusta, GA 30907-6521
Phone (770) 206-3397

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
516GAMDAcupuncturist
006560NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Divine Medicine LLC Acupuncturist Current Accepting new patients
Dr Cho Acupuncture Clinic LLC Acupuncturist PastSince May 3, 2020 Accepting new patients

Locations

11180 State Bridge Rd
Ste 205
Johns Creek, GA 30022
Phone (678) 358-9672

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.

NPI Registry JSON

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

{
    "created_epoch": "1570233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1235770744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5192 LOWER CREEK ST",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300922395",
            "telephone_number": "347-331-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11180 STATE BRIDGE RD STE 205",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300227483",
            "telephone_number": "770-703-9939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2915 Professional Pkwy Ste D",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309076521",
            "country_code": "US",
            "telephone_number": "770-206-3397",
            "fax_number": "706-786-0777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHO",
        "first_name": "PYUNG GANG",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-05",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "006560",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "GA",
            "license": "516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.