Mary M. Kim, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

050031 Issued in GA

Practice address

1624 Mars Hill Rd
Suite B
Watkinsville, GA 30677-4813

Phone

(706) 310-1030

Fax

(706) 705-1444

NPI assigned

Dec 1, 2005

Last updated

Aug 4, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Internal Medicine

Education

Medical College of Georgia School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Oconee Primary Care, L.L.C.Group PAC ID 4981749470, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mary's Hospital Hospital, Athens, GA, CCN 110006
• Piedmont Athens Regional Medical Center Hospital, Athens, GA, CCN 110074

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oconee Primary Care, L.L.C.

  • Internal Medicine Physician
  • Watkinsville, GA
  • NPI 1275860900
  Medicare reassignment Care Compare group NPD
• Papp Clinic Laboratory

  • Clinical Medical Laboratory
  • Newnan, GA
  • NPI 1932353042
  NPD (past)

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

• Piedmont Athens Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Athens, GA
  • NPI 1437186111
  Care Compare affiliation
• St. Mary's Hospital, Inc.

  dba St. Mary's Hospital

  • General Acute Care Hospital
  • Athens, GA
  • NPI 1871556621
  Care Compare affiliation

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312416000000",
    "number": "1902880123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 MARS HILL RD",
            "address_2": "SUITE B",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306774813",
            "telephone_number": "706-310-1030",
            "fax_number": "706-705-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 MARS HILL RD",
            "address_2": "SUITE B",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306774813",
            "telephone_number": "706-310-1030",
            "fax_number": "706-705-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MARY",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2011-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "050031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00904142A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teddy M Kemp, LMFT, LCSW
• Virginia H Kemp, NP
• Bryce Kerr, MD
• Tammy J Kiefer, D.C.
• Jane Kilgo, LPC
• Richard Herman Kimmich, OD
• Taylor Smith King
• Zachary John King
• Deborah Hydrick Kirkland, M. ED.
• Ingrid Knight, RD

• Internal Medicine Physician in Watkinsville, GA
• Providers in Watkinsville, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; 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.