Individual provider Active NPI

Soojeong Kim Hong, RPH

  • Pharmacist
  • Duluth, GA
National Provider Identifier
1750411583
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
40390 Issued in FL
Practice address
3500 Gwinnett Place Dr Ste 15
Duluth, GA 30096-4751
Phone
(770) 837-0571
Fax
(770) 837-0571
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 40390 FL Primary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X RPH025562 GA

Addresses

Primary practice location

3500 Gwinnett Place Dr Ste 15
Duluth, GA 30096-4751

Mailing address

3500 Gwinnett Place Dr Ste 15
Duluth, GA 30096-4751
Phone (770) 837-0571

Other identifiers 1

IdentifierTypeStateIssuer
003168271AMedicaidGA

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)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
40390FLMDPharmacist
RPH025562GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Yes Pharmacy Inc. Current Accepting new patients

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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1750411583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 GWINNETT PLACE DR STE 15",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964751",
            "telephone_number": "770-837-0571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 GWINNETT PLACE DR STE 15",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964751",
            "telephone_number": "770-837-0571",
            "fax_number": "770-837-0571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM HONG",
        "first_name": "SOOJEONG",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "40390",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH025562",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003168271A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.