Emily Mimi Kang

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

79636 Issued in GA

Practice address

4855 River Green Pkwy Ste 140
Duluth, GA 30096-8333

Phone

(678) 417-0077

NPI assigned

Jun 22, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Emily Mimi Kim Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Excelsior Healthcare Partners LLC

  • Family Medicine Physician
  • Norcross, GA
  • NPI 1578305199

  Internal Medicine

  Medicare reassignment NPD
• Northside Hospital, Inc.

  dba Northside Hospital Gwinnett

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Medicare reassignment NPD
• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956
  Medicare reassignment NPD
• Young Won Kang M.D. P.C.

  • Clinic/Center
  • Duluth, GA
  • NPI 1447438874
  Medicare reassignment NPD
• Gwinnett Pathology Assoc PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Lawrenceville, GA
  • NPI 1104887330
  NPD
• Northside Hospital, Inc.

  dba Northside Hospital Duluth

  • General Acute Care Hospital
  • Duluth, GA
  • NPI 1790715381
  NPD

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1750763173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 RIVER GREEN PKWY STE 140",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300968333",
            "telephone_number": "678-417-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 RIVER GREEN PKWY STE 140",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300968333",
            "telephone_number": "678-417-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "EMILY",
        "middle_name": "MIMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-22",
        "last_updated": "2025-06-19",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "79636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "KIM",
            "middle_name": "MIMI",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kaiser Foundation Health Plan of Georgia, Inc. (Kaiser Permanente Gwinnett)
• Kaiser Foundation Health Plan of Georgia, Inc. (Kaiser Permanente)
• Kaiser Foundation Health Plan of Georgia, Inc. (Kaiser Permanente Gwinnett Home Infusion Retail Pharmacy)
• Poonam Kalaria
• Brandon Sang Joon Kang, MD
• Hyung Gi Kang, D.C.
• Larry Kang, M.D.
• Rachel J Kang, BCBA
• Sungtaek Kang, L AC
• Thomas Young Kang, PA-C

• Internal Medicine Physician in Duluth, GA
• Providers in Duluth, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.