Gina Kim, NP-C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

RN204356 Issued in GA

Practice address

121 Langley Dr
Lawrenceville, GA 30046-6930

Phone

(770) 685-1300

Fax

(770) 685-1311

NPI assigned

May 29, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Practice roles

Locations

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.

• Hope Clinic, Inc.

  • Internal Medicine Physician
  • Lawrenceville, GA
  • NPI 1780803460
  Medicare reassignment NPD
• Vision Medical Consulting, P.C.

  • Family Medicine Physician
  • Tucker, GA
  • NPI 1073562922
  NPD (past)

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

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1629415880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 LANGLEY DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300466930",
            "telephone_number": "770-685-1300",
            "fax_number": "770-685-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 LANGLEY DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300466930",
            "telephone_number": "770-685-1300",
            "fax_number": "770-685-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "GINA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-29",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN204356",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "AG0513003",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Joon Ki Kim, MD, PHARMD
• Eda Moonhi Kim, M.D.
• Edmund Sung Joon Kim, M.D.
• Eugene Kim, D.M.D.
• Ga U Kim
• Han N Kim, NP
• James Hankil Kim, MD
• Jessica Ann Kim
• Jessica Jin-Young Kim
• Ji Young Kim, PHARMD

• Gerontology Nurse Practitioner in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Gerontology Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.