North of Atlanta Pain Clinic, LLC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

70798 Issued in GA

Legal business name

NORTH OF ATLANTA PAIN CLINIC, LLC

Practice address

3473 Satellite Blvd
120 N
Duluth, GA 30096-8690

Phone

(201) 741-2448

NPI assigned

Jan 25, 2017

Last updated

Jan 25, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Myung Jae Yoo, MD

Title

Ceo

Phone

(201) 741-2448

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19461/brand/1/csg/1/fhir/r4

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Myung Jae Yoo, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Duluth, GA
  • NPI 1518120955
  Medicare reassignment Care Compare group NPD
• Marry Ann He, NP

  • Nurse Practitioner
  • Lanett, AL
  • NPI 1952982027

  GA

  Medicare reassignment Care Compare group NPD
• Olga Colac

  • Family Nurse Practitioner
  • Stone Mountain, GA
  • NPI 1245553015
  Medicare reassignment NPD
• Minjoo Kim

  • Family Nurse Practitioner
  • Duluth, GA
  • NPI 1447165378
  NPD (past)
• Kiseok Kwon, DPT

  • Physical Therapist
  • Duluth, GA
  • NPI 1508234311
  NPD (past)

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485302400000",
    "number": "1821535154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3473 SATELLITE BLVD",
            "address_2": "120 N",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300968690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3473 SATELLITE BLVD",
            "address_2": "120 N",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300968690",
            "telephone_number": "201-741-2448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH OF ATLANTA PAIN CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-25",
        "last_updated": "2017-01-25",
        "status": "A",
        "authorized_official_last_name": "YOO",
        "authorized_official_first_name": "MYUNG JAE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "201-741-2448",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "GA",
            "license": "70798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Duluth, GA
• Providers in Duluth, GA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.