Young-Tae Kim

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

8783 Issued in GA

Practice address

3610 Peachtree Industrial Blvd Ste 100
Duluth, GA 30096-5139

Phone

(678) 417-0332

NPI assigned

Jun 22, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Woun Hue Seok DO PC

  • Family Medicine Physician
  • Duluth, GA
  • NPI 1821286956
  Medicare reassignment

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529625600000",
    "number": "1902391923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 PEACHTREE INDUSTRIAL BLVD STE 100",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965139",
            "telephone_number": "678-417-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 PEACHTREE INDUSTRIAL BLVD STE 100",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965139",
            "telephone_number": "678-417-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YOUNG-TAE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-22",
        "last_updated": "2018-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "8783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sun Chun Kim, DDS
• Sung H Kim
• Yejin Kim, M.D.
• Yongdong Kim, PHARM D
• Young D Kim, APRN
• Kim'S Acupuncture and Chiropractic
• Kim'S Eyeland Optical, Inc.
• Zachary Kimbler
• Kims Eyeland Optical, Inc.
• Faithe Beanne Kimsey, MS, LPC, NCC

• Family Medicine Physician in Duluth, GA
• Providers in Duluth, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.