Yeunjung Kim, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

89369 Issued in GA

Practice address

1436 Broadrick Dr
Dalton, GA 30720-3009

Phone

(706) 226-3434

Fax

(706) 226-4820

NPI assigned

Mar 25, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Grant Kim Other name

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Interventional Cardiology

Education

Miami Medical College, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside CV Professional Services LLCGroup PAC ID 4880003771, 53 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
• Northside Hospital Duluth Hospital, Duluth, GA, CCN 110252
• Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
• Northside Hospital Hospital, Atlanta, GA, CCN 110161

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ykim19756@hhcs.direct-ci.com

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.

• Northside CV Professional Services LLC

  • Cardiovascular Disease Physician
  • Lawrenceville, GA
  • NPI 1821612938
  Medicare reassignment Care Compare group NPD
• Hamilton Medical Center, Inc.

  • General Acute Care Hospital
  • Dalton, GA
  • NPI 1528056066
  Medicare reassignment NPD
• Hamilton Physician Group Inc

  • Cardiovascular Disease Physician
  • Dalton, GA
  • NPI 1235455569
  Medicare reassignment NPD
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  NPD
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Cumming, GA
  • NPI 1376574277
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Duluth, GA
  • NPI 1790715381
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation

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

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1881936037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1436 BROADRICK DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203009",
            "telephone_number": "706-226-3434",
            "fax_number": "706-226-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 BROADRICK DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203009",
            "telephone_number": "706-226-3434",
            "fax_number": "706-226-4820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Dalton",
            "state": "GA",
            "postal_code": "307202529",
            "country_code": "US",
            "telephone_number": "706-272-6000",
            "fax_number": "706-226-4820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "YEUNJUNG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-25",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A168375",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A168375",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "89369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRANT",
            "last_name": "KIM",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Christina Bush Kight, OTR/L
• Kathie Kile, LCSW
• Brittney Nicole Kilgore
• Daniel Kim
• Dooho Brian Kim, MD
• Erick Anderson Kimmerling, D.O.
• Kristen King
• Tabitha Renee King, PTA
• Justin Kirkpatrick, FNP-C
• Carol Deniece Kistler

• Interventional Cardiology Physician in Dalton, GA
• Providers in Dalton, GA by specialty
• Interventional Cardiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; 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.