Active NPI
Amanda Jennifer Kim
- Anesthesiologist Assistant
- Atlanta, GA
National Provider Identifier
1356299549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiologist Assistant
- Practice address
- 1364 Clifton Rd NE
Atlanta, GA 30322-1059 - Phone
- (404) 778-5040
- NPI assigned
- Mar 21, 2026
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Anesthesiologist Assistant | 367H00000X | Primary |
Addresses
Primary practice location
1364 Clifton Rd NE
Atlanta, GA 30322-1059
Mailing address
11936 Gorham Ave Apt 101
Los Angeles, CA 90049-5360
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1774051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774051200000",
"number": "1356299549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11936 GORHAM AVE APT 101",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900495360"
},
{
"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": "404-778-5040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "AMANDA",
"middle_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-03-21",
"last_updated": "2026-03-21",
"certification_date": "2026-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": null,
"license": null,
"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 Mar 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.