Soyung Kim, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT002737 Issued in GA

Practice address

3645 Habersham Rd. Suite 109
Family Eye Care Center of Atlanta
Atlanta, GA 30305

Phone

(404) 549-9999

Fax

(713) 743-0963

NPI assigned

May 31, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Family Eye Care Center of Atlanta, Inc

  • Optometrist
  • Morrow, GA
  • NPI 1154569069
  NPD (past)

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486684800000",
    "number": "1306849732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3645 HABERSHAM RD. SUITE 109",
            "address_2": "FAMILY EYE CARE CENTER OF ATLANTA",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30305",
            "telephone_number": "713-743-1921",
            "fax_number": "713-743-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3645 HABERSHAM RD. SUITE 109",
            "address_2": "FAMILY EYE CARE CENTER OF ATLANTA",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30305",
            "telephone_number": "404-549-9999",
            "fax_number": "713-743-0963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SOYUNG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-31",
        "last_updated": "2017-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1666760-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Selena Kim, CAA
• Serye Kim
• Shelley E Kim, M.D.
• Shelly Anne Kim, PA-C
• Sophia Kim, MD
• Steven C Kim, M.D.
• Sun Y Kim, RPH
• Tae Youn Kim
• Yiji M Kim, PHARMD
• Yong Kyun Kim

• Optometrist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.