Atlanta Internal Medicine PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

64660 Issued in GA

Legal business name

ATLANTA INTERNAL MEDICINE PC

Practice address

2400 Pleasant Hill Rd
Suite 300
Duluth, GA 30096-4396

Phone

(770) 858-5252

NPI assigned

Jan 2, 2015

Organization subpart

No

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

Authorized official

Name

Jo Kim, D.O.NPI 1205092921

Title

Ceo

Phone

(770) 858-5252

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jo Myeong Kim, DO

  • Internal Medicine Physician
  • Duluth, GA
  • NPI 1205092921
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1420156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420243200000",
    "number": "1639567472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 PLEASANT HILL RD",
            "address_2": "SUITE 300",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964396",
            "telephone_number": "770-858-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 PLEASANT HILL RD",
            "address_2": "SUITE 300",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964396",
            "telephone_number": "770-858-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA INTERNAL MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-02",
        "last_updated": "2015-01-03",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-858-5252",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "64660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003109338A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Duluth, GA
• Providers in Duluth, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.