Active NPI
Christin Kim, NP
- Family Nurse Practitioner
- Tucker, GA
National Provider Identifier
1508620030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN315084
- Practice address
- 1468 Montreal Rd
Tucker, GA 30084-6901 - Phone
- (770) 638-1400
- NPI assigned
- Feb 6, 2024
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN315084 | GA | Primary |
Addresses
Primary practice location
1468 Montreal Rd
Tucker, GA 30084-6901
Mailing address
3497 Greyhawk Xing
Buford, GA 30519-5077
Phone (404) 509-1176
Other practice location 1
3275 Market Place Blvd Ste 100
Cumming, GA 30041-7977
Phone (678) 679-6800
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN315084 | GA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atlanta Heart Specialists LLC | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/FIFCAA
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.
-
- Cardiovascular Disease Physician
- Tucker, GA
- NPI 1891881827
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726012800000",
"number": "1508620030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3497 GREYHAWK XING",
"city": "BUFORD",
"state": "GA",
"postal_code": "305195077",
"telephone_number": "404-509-1176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1468 MONTREAL RD",
"city": "TUCKER",
"state": "GA",
"postal_code": "300846901",
"telephone_number": "770-638-1400"
}
],
"practiceLocations": [
{
"address_1": "3275 Market Place Blvd Ste 100",
"address_purpose": "LOCATION",
"city": "Cumming",
"state": "GA",
"postal_code": "300417977",
"country_code": "US",
"telephone_number": "678-679-6800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "CHRISTIN",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-06",
"last_updated": "2024-09-11",
"certification_date": "2024-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "RN315084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tucker, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.