Reo Jin Kim, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN202224 Issued in GA

Practice address

10710 Medlock Bridge Rd Ste 200
Johns Creek, GA 30097-1998

Phone

(770) 497-4188

NPI assigned

Aug 16, 2021

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

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: reo.jin.kim.1@8258.direct.athenahealth.com

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1588339170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10710 MEDLOCK BRIDGE RD STE 200",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971998",
            "telephone_number": "704-974-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10710 MEDLOCK BRIDGE RD STE 200",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971998",
            "telephone_number": "770-497-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "REO",
        "middle_name": "JIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN202224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regina Khanna, MD
• Farzeen Ahmed Khurram, M.D.
• Meagan G Kidd, M.ED.CCC-SLP
• Hyoun Kim
• Myoung Kim
• Sam Kim
• Robert Kirby, DPT
• Meredith Lee Kirk, NP-C
• Cameron Christopher Kirkwood
• Alyssa Kiss

• Family Nurse Practitioner in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.