Individual provider Active NPI

Sam Kim

  • Acupuncturist
  • Johns Creek, GA
National Provider Identifier
1821264284
Registry record updated Jul 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
200 Issued in GA
Practice address
6290 Abbotts Bridge Rd Ste 203
Johns Creek, GA 30097-1750
Phone
(770) 696-4714
NPI assigned
May 6, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 200 GA Primary

Addresses

Primary practice location

6290 Abbotts Bridge Rd Ste 203
Johns Creek, GA 30097-1750

Mailing address

6290 Abbotts Bridge Rd Ste 203
Johns Creek, GA 30097-1750
Phone (770) 696-4714

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

LicenseStateTypeSpecialty
200GAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342051200000",
    "number": "1821264284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6290 ABBOTTS BRIDGE RD STE 203",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971750",
            "telephone_number": "770-696-4714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6290 ABBOTTS BRIDGE RD STE 203",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971750",
            "telephone_number": "770-696-4714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-06",
        "last_updated": "2012-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "GA",
            "license": "200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; 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.