Individual provider Active NPI

Sungtaek Kang, L AC

  • Acupuncturist
  • Duluth, GA
National Provider Identifier
1831665033
Registry record updated Oct 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
000421 Issued in GA
Practice address
3296 Summit Ridge Pkwy Ste 320
Duluth, GA 30096-6301
Phone
(470) 282-1075
NPI assigned
Oct 16, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 000421 GA Primary

Addresses

Primary practice location

3296 Summit Ridge Pkwy Ste 320
Duluth, GA 30096-6301

Mailing address

3296 Summit Ridge Pkwy Ste 320
Duluth, GA 30096-6301

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
000421GAMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1831665033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3296 SUMMIT RIDGE PKWY STE 320",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300966301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3296 SUMMIT RIDGE PKWY STE 320",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300966301",
            "telephone_number": "470-282-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "SUNGTAEK",
        "credential": "L AC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-16",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "GA",
            "license": "000421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; 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.