Individual provider Active NPI

Jong Jin Choi, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Tucker, GA
National Provider Identifier
1295845584
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
052043 Issued in GA
Practice address
2060 Northlake Pkwy
Tucker, GA 30084-7012
Phone
(678) 245-6235
Fax
(770) 710-0925
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MD019395E PA
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 052043 GA Primary

Addresses

Primary practice location

2060 Northlake Pkwy
Tucker, GA 30084-7012

Mailing address

2060 Northlake Pkwy
Tucker, GA 30084-7012
Phone (678) 245-6235

Other identifiers 1

IdentifierTypeStateIssuer
003131467AMedicaidGA

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
I20111026000355 GA Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 9830137199 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD019395EPAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Physician Associates PC CurrentSince Dec 1, 2013 Accepting new patients
Georgia Physician Associates, PC CurrentSince Dec 1, 2013 Accepting new patients
Medical Rehabilitation, Inc Past Accepting new patients
Comprehensive Rehab Care Physicians Physical Medicine & Rehabilitation Past Accepting new patients
Maria Parham Nephrology & Hypertension Past Accepting new patients
Quality Medical Management Services LLC Past Accepting new patients
Maria Parham Anesthesia and Physiatry Center, Inc Past Accepting new patients

Locations

5745 Old Winder Hwy
Ste C
Braselton, GA 30517
Phone (770) 450-6350

2000 Village Professional Dr
Ste 200
Canton, GA 30114
Phone (678) 661-4545

2060 Northlake Pkwy
Tucker, GA 30084
Phone (404) 644-3410

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 7

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1295845584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 NORTHLAKE PKWY",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300847012",
            "telephone_number": "678-245-6235",
            "fax_number": "770-710-0925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 NORTHLAKE PKWY",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300847012",
            "telephone_number": "678-245-6235",
            "fax_number": "770-710-0925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "JONG",
        "middle_name": "JIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD019395E",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "GA",
            "license": "052043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003131467A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

Verify at the official NPI Registry.