Active NPI
Yoo Bin Jin
- Pharmacist
- Blackshear, GA
National Provider Identifier
1790077808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH025854
- Practice address
- 3537 US Highway 84
Blackshear, GA 31516-2237 - Phone
- (912) 449-0811
- NPI assigned
- May 8, 2011
- Last updated
- Aug 12, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH025854 | GA | Primary |
Addresses
Primary practice location
3537 US Highway 84
Blackshear, GA 31516-2237
Mailing address
2975 Delk Rd SE
Marietta, GA 30067-5318
Phone (770) 933-9782
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH025854 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597190400000",
"number": "1790077808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2975 DELK RD SE",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300675318",
"telephone_number": "770-933-9782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3537 US HIGHWAY 84",
"city": "BLACKSHEAR",
"state": "GA",
"postal_code": "315162237",
"telephone_number": "912-449-0811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIN",
"first_name": "YOO BIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-08",
"last_updated": "2020-08-12",
"certification_date": "2020-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH025854",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blackshear, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.