Shelley E Kim, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

52763 Issued in GA

Practice address

3367 Buford Hwy NE
Suite 910
Atlanta, GA 30329-1833

Phone

(678) 843-8700

Fax

(404) 633-0502

NPI assigned

Aug 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Little Five Points Pediatrics LLC

  • Pediatrics Physician
  • Atlanta, GA
  • NPI 1922588474
  NPD (past) Authorized official
• Victor G. Polizos MD PC

  • Pediatric Adolescent Medicine Physician
  • Atlanta, GA
  • NPI 1689901597
  NPD (past)

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1528174117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3367 BUFORD HWY NE",
            "address_2": "SUITE 910",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303291833",
            "telephone_number": "678-843-8700",
            "fax_number": "404-633-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3367 BUFORD HWY NE",
            "address_2": "SUITE 910",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303291833",
            "telephone_number": "678-843-8700",
            "fax_number": "404-633-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SHELLEY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "52763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "977586582B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "977586582C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rila Kim, MD
• Samuel Jinsu Kim, RN
• Sang Kim
• Selena Kim, CAA
• Serye Kim
• Shelly Anne Kim, PA-C
• Sophia Kim, MD
• Soyung Kim, O.D.
• Steven C Kim, M.D.
• Sun Y Kim, RPH

• Pediatrics Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2014; 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.