Individual provider Active NPI

Timothy Byeongan Han

  • Acupuncturist
  • Norcross, GA
National Provider Identifier
1497133383
Registry record updated Dec 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
456 Issued in GA
Practice address
3985 Steve Reynolds Blvd Ste J
Norcross, GA 30093-3068
Phone
(470) 550-9101
Fax
(800) 886-9976
NPI assigned
May 11, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC15295 CA
Acupuncturist 171100000X 456 GA Primary

Addresses

Primary practice location

3985 Steve Reynolds Blvd Ste J
Norcross, GA 30093-3068

Mailing address

3985 Steve Reynolds Blvd Ste J
Norcross, GA 30093-3068
Phone (470) 550-9101

Other names 1

  • Byeongan Han Former name

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

LicenseStateTypeSpecialty
AC15295CAMDAcupuncturist
456GAMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1497133383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3985 STEVE REYNOLDS BLVD STE J",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300933068",
            "telephone_number": "470-550-9101",
            "fax_number": "800-886-9976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3985 STEVE REYNOLDS BLVD STE J",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300933068",
            "telephone_number": "470-550-9101",
            "fax_number": "800-886-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "TIMOTHY",
        "middle_name": "BYEONGAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-11",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC15295",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "GA",
            "license": "456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BYEONGAN",
            "last_name": "HAN",
            "credential": "L.AC.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.