Georgia Gwinnett Clinic

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

CHIR008710 Issued in GA

Legal business name

GEORGIA GWINNETT CLINIC

Practice address

2856 Buford Highway
Suite 7
Duluth, GA 30096

Phone

(678) 587-5390

Fax

(678) 587-5314

NPI assigned

May 22, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Charles Byung Kim

Title

Manager

Phone

(678) 587-5390

Specialties & licenses 1

Addresses

Practitioners 1

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

• Byung Yull Kim, D.C.

  • Sports Physician Chiropractor
  • Duluth, GA
  • NPI 1336434109
  NPD

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369180800000",
    "number": "1720424310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2856 BUFORD HIGHWAY",
            "address_2": "SUITE 7",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30096",
            "telephone_number": "678-587-5390",
            "fax_number": "678-587-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2856 BUFORD HIGHWAY",
            "address_2": "SUITE 7",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30096",
            "telephone_number": "678-587-5390",
            "fax_number": "678-587-5314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA GWINNETT CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-22",
        "last_updated": "2013-05-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "BYUNG",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "678-587-5390",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "GA",
            "license": "CHIR008710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Physician Chiropractor in Duluth, GA
• Providers in Duluth, GA by specialty
• Sports Physician Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.