NPIMap

Individual provider Active NPI

Seung Yun Kim, MD

  • Neurology Physician
  • Dawsonville, GA
National Provider Identifier
1316567779
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
104336 Issued in GA
Practice address
81 Prominence CT Ste 200
Dawsonville, GA 30534-6372
Phone
(770) 219-6520
NPI assigned
Apr 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MT219780 PA
Neurology Physician 2084N0400X 104336 GA Primary

Addresses

Primary practice location

81 Prominence CT Ste 200
Dawsonville, GA 30534-6372

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

1700 St Lukes Blvd
Easton, PA 18045-5670
Phone (484) 526-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250922001789 GA Practitioner - Neurology 2365872579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Temple University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Georgia Physicians Group IncGroup PAC ID 6901898386, 884 clinicians

Practice addresses (Care Compare)

1315 Jesse Jewell Pkwy NE
Suite 300
Gainesville, GA 30501-3822
Phone (770) 219-6520

Hospital & facility affiliations

  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
  • Northeast Georgia Medical Center Lumpkin Hospital, Dahlonega, GA, CCN 110237
  • Northeast Georgia Medical Center Habersham Hospital, Demorest, GA, CCN 110041
  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104336GAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc Neurology CurrentSince Aug 26, 2025 Accepting new patients

Locations

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

1315 Jesse Jewell Pkwy NE
Ste 300
Gainesville, GA 30501
Phone (770) 219-6520

Organizations & group practices 1

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 9

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": "1587772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1316567779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 PROMINENCE CT STE 200",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305346372",
            "telephone_number": "770-219-6520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 St Lukes Blvd",
            "address_purpose": "LOCATION",
            "city": "Easton",
            "state": "PA",
            "postal_code": "180455670",
            "country_code": "US",
            "telephone_number": "484-526-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "SEUNG",
        "middle_name": "YUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-25",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MT219780",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "104336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dawsonville, GA

Sources for this page

Verify at the official NPI Registry.