Active NPI
Jinyoung Kim
- Diagnostic Radiology Physician
- Atlanta, GA
National Provider Identifier
1336089804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- NONE
- Practice address
- 1364 Clifton Rd NE
Atlanta, GA 30322-1059 - Phone
- (470) 404-9730
- NPI assigned
- Apr 1, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | NONE | GA | Primary |
Addresses
Primary practice location
1364 Clifton Rd NE
Atlanta, GA 30322-1059
Mailing address
497 Raven Brook LN
Suwanee, GA 30024-8790
Phone (470) 404-9730
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260518002391 | GA | Order and Referring Only - Diagnostic Radiology | 2062981194 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NONE | GA | MD | Interpreter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1775001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775001600000",
"number": "1336089804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "497 RAVEN BROOK LN",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300248790",
"telephone_number": "470-404-9730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1364 CLIFTON RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303221059",
"telephone_number": "470-404-9730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JINYOUNG",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-04-01",
"last_updated": "2026-04-01",
"certification_date": "2026-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "GA",
"license": "NONE",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; 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.