Jennifer Lee Kim, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

074038 Issued in GA

Practice address

1000 Corporate Center Dr
Suite 100
Morrow, GA 30260-4180

Phone

(770) 968-8888

Fax

(770) 960-2473

NPI assigned

Apr 7, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

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

Specialty

Ophthalmology

Education

Morehouse School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Care Centers Management, IncGroup PAC ID 5092701342, 13 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.51 of 100Reported as group

Quality

99.1

Improvement activities

40

Cost

79.55

Procedures performed for Medicare patients

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.

• Eye Care Centers Management Inc

  • Ophthalmology Physician
  • Morrow, GA
  • NPI 1699888131
  Medicare reassignment Care Compare group NPD
• Joon Y. Kim, MD, PC

  • Ambulatory Surgical Clinic/Center
  • Morrow, GA
  • NPI 1629181136
  Medicare reassignment NPD
• Eye Care Centers Management Inc

  • Eyewear Supplier
  • Morrow, GA
  • NPI 1316094576

  Ophthalmology

  NPD (past)

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

{
    "created_epoch": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544486400000",
    "number": "1811286149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 CORPORATE CENTER DR",
            "address_2": "SUITE 100",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302604180",
            "telephone_number": "770-968-8888",
            "fax_number": "770-960-2473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CORPORATE CENTER DR",
            "address_2": "SUITE 100",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302604180",
            "telephone_number": "770-968-8888",
            "fax_number": "770-960-2473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-07",
        "last_updated": "2018-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "074038",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "38366",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYE CARE CENTERS MANAGEMENT, INC. D/B/A CLAYTON EYE CENTER",
            "identifier": "581787543",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003181756A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Damien Diablo Kellam, M.A., LPC, PHD ABD
• Scott A. Kelly, M.D.
• Shelitha Kent, RBT
• KG Family Eye Clinic PC
• Chan Yoon Kim, OD
• Joon Y Kim, M.D.
• Maria Kinas
• Kings Quality Care
• Rodney Knight, LPC
• Bessie Koryan, FNP

• Ophthalmology Physician in Morrow, GA
• Providers in Morrow, GA by specialty
• Ophthalmology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.