Active NPI
Jo Seung Kim
- Pharmacist
- Cumming, GA
National Provider Identifier
1356623193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH022790
- Practice address
- 2595 Peachtree Pkwy
Cumming, GA 30041-7223 - Phone
- (678) 455-4544
- Fax
- (678) 455-7201
- NPI assigned
- Sep 19, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH022790 | GA | Primary |
Addresses
Primary practice location
2595 Peachtree Pkwy
Cumming, GA 30041-7223
Mailing address
2721 Heathrow Dr
Lawrenceville, GA 30043-8172
Phone (678) 455-4544
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH022790 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Express Pharmacy Inc | Current | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316390400000",
"number": "1356623193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2721 HEATHROW DR",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300438172",
"telephone_number": "678-455-4544",
"fax_number": "678-455-7201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2595 PEACHTREE PKWY",
"city": "CUMMING",
"state": "GA",
"postal_code": "300417223",
"telephone_number": "678-455-4544",
"fax_number": "678-455-7201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JO",
"middle_name": "SEUNG",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-19",
"last_updated": "2011-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH022790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cumming, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.