NPIMap

Organization Active NPI

JK Health Care Group, Inc

  • Chiropractor
  • Duluth, GA
National Provider Identifier
1366794786
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR007922 Issued in GA
Legal business name
JK HEALTH CARE GROUP, INC
Practice address
3775 Venture Dr
BLD #N
Duluth, GA 30096-5102
Phone
(770) 817-9608
Fax
(770) 817-9610
NPI assigned
Oct 9, 2012
Last updated
Oct 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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

Authorized official

Name
Dr. Jung B Kim, DCNPI 1265648539
Title
President
Phone
(770) 817-9608

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR007922 GA Primary

Addresses

Primary practice location

3775 Venture Dr
BLD #N
Duluth, GA 30096-5102

Mailing address

3775 Venture Dr
BLD #N
Duluth, GA 30096-5102
Phone (770) 817-9608

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120928000126 GA Part B Supplier - Clinic/Group Practice 0648429035 Receives reassigned benefits from 1 practitioner
Practice locations: Duluth, GA

National Provider Directory

National Provider Directory
Tax ID family
8CM Grace Chiropractic Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3775 Venture Dr
Bldg N
Duluth, GA 30096
Phone (770) 817-9608

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349740800000",
    "number": "1366794786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3775 VENTURE DR",
            "address_2": "BLD #N",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965102",
            "telephone_number": "770-817-9608",
            "fax_number": "770-817-9610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3775 VENTURE DR",
            "address_2": "BLD #N",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965102",
            "telephone_number": "770-817-9608",
            "fax_number": "770-817-9610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JK HEALTH CARE GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-09",
        "last_updated": "2012-10-09",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JUNG",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-817-9608",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR007922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.