Family Medicine of Gwinnett, LLC

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

License

046142 Issued in GA

Legal business name

FAMILY MEDICINE OF GWINNETT, LLC

Practice address

1742 Oak Road
Snellville, GA 30078

Phone

(770) 638-1401

Fax

(770) 638-1402

NPI assigned

Jun 18, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Yong S Kim, MD

Title

Doctor/Owner

Phone

(770) 638-1401

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245283200000",
    "number": "1255568150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1742 OAK ROAD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "30078",
            "telephone_number": "770-638-1401",
            "fax_number": "770-638-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1742 OAK ROAD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "30078",
            "telephone_number": "770-638-1401",
            "fax_number": "770-638-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICINE OF GWINNETT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-18",
        "last_updated": "2009-06-18",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "YONG",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "770-638-1401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "GA",
            "license": "046142",
            "primary": true
        },
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "GA",
            "license": "046142",
            "primary": false
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "GA",
            "license": "046142",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Extraordinary Family Healthcare
• Kaitlyn Eyer
• James Fabricant, RBT
• Sabrina O. Falkner, M.D.
• Family Medical Clinic of Snellville
• Family Nutrition Solutions, LLC
• Babatunde A Famuyiwa, AA
• Idil Farah
• Patricia Farley, PH.D.
• James Farmer, RBT

• Public Health or Welfare Agency in Snellville, GA
• Providers in Snellville, GA by specialty
• Public Health or Welfare Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; 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.