Individual provider Active NPI

Som I Kwon, OD

  • Optometrist
  • Suwanee, GA
National Provider Identifier
1982200283
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003356 Issued in GA
Practice address
80 Horizon Dr Ste 504-601a
Suwanee, GA 30024-2936
Phone
(678) 990-2020
Fax
(678) 990-2220
NPI assigned
Dec 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003356 GA Primary

Addresses

Primary practice location

80 Horizon Dr Ste 504-601a
Suwanee, GA 30024-2936

Mailing address

80 Horizon Dr Ste 504-601a
Suwanee, GA 30024-2936
Phone (678) 990-2020

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231220002422 GA Practitioner - Optometry 8729490537 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

80 Horizon Dr
Suite 504 601a
Suwanee, GA 30024-2936
Phone (678) 990-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Voda Eye Group, LLC Optometrist CurrentSince Oct 19, 2024 Accepting new patients
Gainesville Eye Associates LLC Optometrist CurrentSince Nov 27, 2023 Accepting new patients
Gainesville Eye Associates LLC Optometrist CurrentSince Nov 27, 2023 Accepting new patients

Locations

2061 Beverly Rd
Gainesville, GA 30501
Phone (706) 867-4116

80 Horizon Dr
Ste 504601A
Suwanee, GA 30024
Phone (678) 990-2020

500 Ross St
Pittsburgh, PA 15262
Phone (844) 362-6808

Interoperability endpoints

  • Direct secure messaging: skwon@esp.intellechartdirect.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1982200283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 HORIZON DR STE 504-601A",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242936",
            "telephone_number": "678-990-2020",
            "fax_number": "678-990-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 HORIZON DR STE 504-601A",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242936",
            "telephone_number": "678-990-2020",
            "fax_number": "678-990-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "SOM",
        "middle_name": "I",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-10",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.