Individual provider Active NPI

Justin Yoon, D.O.

  • Family Medicine Physician
  • Lawrenceville, GA
National Provider Identifier
1891140240
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
80246 Issued in GA
Practice address
665 Duluth Hwy
Suite 401
Lawrenceville, GA 30046-3328
Phone
(678) 312-4072
Fax
(678) 312-0423
NPI assigned
May 3, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 80246 GA Primary

Addresses

Primary practice location

665 Duluth Hwy
Suite 401
Lawrenceville, GA 30046-3328

Mailing address

4441 Atlanta Rd SE Ste 107
Smyrna, GA 30080-6431
Phone (470) 956-0330

Other practice location 1

4441 Atlanta Rd SE Ste 107
Smyrna, GA 30080-6431
Phone (470) 956-0330

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jyoon394433@directwellstar.org

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20181106001726 GA Practitioner - Family Practice 6800189200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

12201 Hwy 92
Suite D
Woodstock, GA 30188-7141
Phone (770) 517-4621

12460 Crabapple Rd
Suite 901
Alpharetta, GA 30004-6392
Phone (678) 762-0574

2890 Delk Serd
Marietta, GA 30067-5326
Phone (770) 955-8620

3747 Roswell Rd
Marietta, GA 30062-6227

3980 Jiles Rd NW
Kennesaw, GA 30144-1109
Phone (678) 504-0100

4477 Towne Lake Pkwy
Suite 130
Woodstock, GA 30189-6720
Phone (770) 249-5620

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

780 Church St NE
Marietta, GA 30060-7269

8901 Stonebridgde Blvd
Suite 100
Douglasville, GA 30134-2253
Phone (943) 202-7100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
80246GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Family Medicine Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Dec 1, 2020 Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

610 Sparta Rd
Sandersville, GA 31082
Phone (478) 240-2000

4441 Atlanta Rd SE
Ste 107
Smyrna, GA 30080
Phone (470) 956-0330

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1891140240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4441 ATLANTA RD SE STE 107",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806431",
            "telephone_number": "470-956-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 DULUTH HWY",
            "address_2": "SUITE 401",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463328",
            "telephone_number": "678-312-4072",
            "fax_number": "678-312-0423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4441 Atlanta Rd SE Ste 107",
            "address_purpose": "LOCATION",
            "city": "Smyrna",
            "state": "GA",
            "postal_code": "300806431",
            "country_code": "US",
            "telephone_number": "470-956-0330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOON",
        "first_name": "JUSTIN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-03",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "80246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jyoon394433@directwellstar.org",
            "affiliation": "N",
            "address_1": "4441 Atlanta Rd SE Ste 107",
            "city": "Smyrna",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300806431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.