Individual provider Active NPI

Hyun Jung Eom, NP

  • Nurse Practitioner
  • Buford, GA
National Provider Identifier
1326658774
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN258622 Issued in GA
Practice address
4200 Easter Lily Ave
Buford, GA 30519-8474
Phone
(850) 293-4856
NPI assigned
Jul 31, 2020
Last updated
Jan 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN258622 GA Primary

Addresses

Primary practice location

4200 Easter Lily Ave
Buford, GA 30519-8474

Mailing address

4200 Easter Lily Ave
Buford, GA 30519-8474
Phone (850) 293-4856

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250617003026 GA Practitioner - Nurse Practitioner 3476064346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Metropolitan Radiology Associates LLPGroup PAC ID 7214825561, 45 clinicians

Practice addresses (Care Compare)

3620 Howell Ferry Rd
Duluth, GA 30096-3178
Phone (678) 312-6800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN258622GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Metropolitan Radiology Associates, LLP CurrentSince Apr 7, 2025 Accepting new patients

Locations

3620 Howell Ferry Rd
Duluth, GA 30096
Phone (678) 312-3294

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1596153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1326658774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 EASTER LILY AVE",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305198474",
            "telephone_number": "850-293-4856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 EASTER LILY AVE",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305198474",
            "telephone_number": "850-293-4856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EOM",
        "first_name": "HYUN JUNG",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-31",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN258622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buford, GA

Sources for this page

Verify at the official NPI Registry.