NPIMap

Organization Active NPI

Mesun Health Services Inc

  • Community Based Hospice Care Agency
  • Lawrenceville, GA
National Provider Identifier
1295793446
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
MESUN HEALTH SERVICES INC
Practice address
88 Johnson Rd
Lawrenceville, GA 30046-5520
Phone
(770) 623-2710
Fax
(770) 623-2711
NPI assigned
May 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Authorized official

Name
Hanson J Kim
Title
President
Phone
(256) 473-0964

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

88 Johnson Rd
Lawrenceville, GA 30046-5520

Mailing address

88 Johnson Rd
Lawrenceville, GA 30046-5520
Phone (770) 623-2710

Other names 1

  • Mesun Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120216000140 GA Part A Provider - Hospice 9739190869 Practice locations: Lawrenceville, GA

Hospice certification: CCN 111635

Legal name
MESUN HEALTH SERVICES INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 17, 2006
Last certification
Jun 27, 2019
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Nov 21, 2005 in GA
Enrollment address
88 Johnson Rd
Lawrenceville, GA 30046-5520

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: Hospice

Medicare Care Compare
Listed as
MesunCCN 111635
Ownership
For-Profit
Certified
Aug 17, 2006
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Mesun Health Services Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
James Son Individual W-2 Managing Employee Aug 1, 2019
Eugene T Kim Individual 5% Or Greater Direct Ownership Interest Mar 28, 2022 100%
W-2 Managing Employee Mar 28, 2022
Hanson Kim Individual 5% Or Greater Direct Ownership Interest Nov 21, 2005 100%
Corporate Director Nov 21, 2005 100%

Owners & managing parties with NPI records 1

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

  • Eugene T Kim, MD
    • Hospice and Palliative Medicine (Family Medicine) Physician
    • Douglasville, GA
    • NPI 1538456843

    5% Or Greater Direct Ownership Interest, W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627344000000",
    "number": "1295793446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 JOHNSON RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300465520",
            "telephone_number": "770-623-2710",
            "fax_number": "770-623-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 JOHNSON RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300465520",
            "telephone_number": "770-623-2710",
            "fax_number": "770-623-2711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESUN HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "HANSON",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-473-0964"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mesun Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.