Individual provider Active NPI

Jeanah Kim

  • Family Medicine Physician
  • Pooler, GA
National Provider Identifier
1235879537
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
104979 Issued in GA
Practice address
101 Saint Josephs Candler Dr Ste 200
Pooler, GA 31322-9585
Phone
(912) 748-1999
Fax
(912) 748-3847
NPI assigned
Apr 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 104979 GA Primary

Addresses

Primary practice location

101 Saint Josephs Candler Dr Ste 200
Pooler, GA 31322-9585

Mailing address

101 Saint Josephs Candler Dr Ste 200
Pooler, GA 31322-9585
Phone (912) 748-1999

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
I20250926003943 GA Practitioner - Family Practice 7517347297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Florida State University College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SJC Medical Group IncGroup PAC ID 7719978105, 57 clinicians

Practice addresses (Care Compare)

11705 Mercy Blvd
Savannah, GA 31419-1711
Phone (912) 819-4949

Hospital & facility affiliations

  • St Joseph'S Hospital - Savannah Hospital, Savannah, GA, CCN 110043
  • Candler Hospital Hospital, Savannah, GA, CCN 110024

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SJC Medical Group Inc Family Medicine CurrentSince Sep 1, 2025 Accepting new patients
Candler Medical Group, Inc. - Islands Family Medicine PastSince Aug 1, 2025 Accepting new patients

Locations

101 Saint Josephs Candler Dr
Ste 200
Pooler, GA 31322
Phone (912) 748-1999

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

836 E 65th St
Ste 22
Savannah, GA 31405
Phone (912) 819-7878

Interoperability endpoints

  • Direct secure messaging: drkimjea@direct.sjchs.org

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.

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": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1235879537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SAINT JOSEPHS CANDLER DR STE 200",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313229585",
            "telephone_number": "912-748-1999",
            "fax_number": "912-748-3847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SAINT JOSEPHS CANDLER DR STE 200",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313229585",
            "telephone_number": "912-748-1999",
            "fax_number": "912-748-3847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JEANAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-01",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "104979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pooler, GA

Sources for this page

Verify at the official NPI Registry.