Active NPI
Ji Yeon Pak
- Body Imaging Physician
- Sandy Springs, GA
National Provider Identifier
1699394593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Body Imaging Physician
- License
- 113531
- Practice address
- 20 Glenlake Pkwy
Sandy Springs, GA 30328-3473 - Phone
- (404) 365-0966
- NPI assigned
- Apr 10, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Body Imaging Physician | 2085B0100X | 113531 | GA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
20 Glenlake Pkwy
Sandy Springs, GA 30328-3473
Mailing address
925 Seneca St Mail Sop: H8-Gme
Seattle, WA 98101
Phone (206) 583-6079
Other practice location 1
925 Seneca St
Seattle, WA 98101-2742
Phone (206) 583-6079
Other practice location 2
75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500
Other names 1
- Janice Jiyeon Pak
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784505600000",
"number": "1699394593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "925 SENECA ST MAIL SOP: H8-GME",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98101",
"telephone_number": "206-583-6079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 GLENLAKE PKWY",
"city": "SANDY SPRINGS",
"state": "GA",
"postal_code": "303283473",
"telephone_number": "404-365-0966"
}
],
"practiceLocations": [
{
"address_1": "925 Seneca St",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981012742",
"country_code": "US",
"telephone_number": "206-583-6079",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "75 Francis St",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021156110",
"country_code": "US",
"telephone_number": "617-732-5500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PAK",
"first_name": "JI YEON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-10",
"last_updated": "2026-07-20",
"certification_date": "2026-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "GA",
"license": "113531",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JANICE",
"last_name": "PAK",
"middle_name": "JIYEON",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Sandy Springs, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.