Individual provider Active NPI

Heeyoung Kim, FNP

  • Family Nurse Practitioner
  • Cumming, GA
National Provider Identifier
1629692637
Registry record updated Jun 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN241994 Issued in GA
Practice address
4375 Granby Cir
Cumming, GA 30041-5804
Phone
(847) 275-4899
NPI assigned
Jun 5, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN241994 GA Primary

Addresses

Primary practice location

4375 Granby Cir
Cumming, GA 30041-5804

Mailing address

4375 Granby Cir
Cumming, GA 30041-5804
Phone (847) 275-4899

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20211201000084 GA Practitioner - Nurse Practitioner 7719377035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
74.39 of 100Reported as group
Quality
44.91
Promoting interoperability
98
Improvement activities
40
Cost
71.38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN241994GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aga, LLC CurrentSince Jan 1, 2022 Accepting new patients

Locations

488 Kennesaw Ave NW
Ste 200
Marietta, GA 30060
Phone (770) 427-3075

2520 Windy Hill Rd SE
Ste 102
Marietta, GA 30067
Phone (770) 612-8165

1340 Upper Hembree Rd
Ste A
Roswell, GA 30076
Phone (770) 569-0777

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

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.

NPI Registry JSON

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591315200000",
    "number": "1629692637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 GRANBY CIR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300415804",
            "telephone_number": "847-275-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 GRANBY CIR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300415804",
            "telephone_number": "847-275-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HEEYOUNG",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN241994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.