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TAE YOUN KIM
NPI 1124895925
Student in an Organized Health Care Education/Training Program in Atlanta, GA

Active since December 11, 2023PECOS Enrolled
1364 CLIFTON RD NE, ATLANTA, GA 30322(404) 778-7777 Get Directions Write a Review

NPPES record last updated: March 25, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 25, 2025, Dec 11, 2023 (2 updates tracked since 2023).

About Tae Youn Kim NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TAE YOUN KIM (NPI 1124895925) is an individual student in an organized health care education/training program in Atlanta, Georgia and active in the NPI registry since December 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124895925
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameTAE YOUN KIM
Location Address1364 CLIFTON RD NEAtlanta, GA 30322-1802
Mailing Address150 Heard StChelsea, MA 02150-1977
Phone(404) 778-7777
Sole ProprietorNo
Enumeration DateDecember 11, 2023
Last NPPES UpdateMarch 25, 20252 updates tracked since enumeration
NPPES CertifiedMarch 25, 2025
✔ NPI 1124895925 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1364 CLIFTON RD NE, Atlanta, GA 30322
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tae Youn Kim is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GREGORY WESTON
Student in an Organized Health Care Education/Training Program
1364 CLIFTON RD NE
ATLANTA, GA 30322
Dekalb County (404) 727-5658
RUTH FLAHERTY CCC-SLP
Physician Assistant
1364 CLIFTON RD NE
ATLANTA, GA 30322
Dekalb County (404) 712-2000
JENNIFER MARIE SCHNETZER RN
Nurse Anesthetist, Certified Registered
1364 CLIFTON RD NE
ATLANTA, GA 30322
Dekalb County (679) 378-1093
PETER MORAN PHARMD
Pharmacist (Critical Care)
1364 CLIFTON RD NE
ATLANTA, GA 30322
Dekalb County (404) 712-2000
SARAH ELIZABETH DUNSEATH MD
Anesthesiology (Critical Care Medicine)
1364 CLIFTON RD NE
ATLANTA, GA 30322
Dekalb County (404) 778-7777
DUYEN M VO PHARMD
Pharmacist (Pharmacotherapy)
1364 CLIFTON RD NE
ATLANTA, GA 30322
Dekalb County (404) 712-7273
CHRISTINE CARPENTER
Anesthesiologist Assistant
1364 CLIFTON RD NE
ATLANTA, GA 30322
Dekalb County (404) 712-2000
DR. CHRISTOPHER VINCENT BARRY MD, PHD, MPH
Student in an Organized Health Care Education/Training Program
1364 CLIFTON RD NE
ATLANTA, GA 30322
Dekalb County (404) 727-5658

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tae Youn Kim's NPI number?

The NPI number for Tae Youn Kim is 1124895925. It was assigned to this individual provider in the NPPES registry on December 11, 2023.

Where is Tae Youn Kim located?

Tae Youn Kim practices at 1364 Clifton Rd NE, Atlanta, GA 30322. The listed phone number is (404) 778-7777.

What is Tae Youn Kim's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Tae Youn Kim enrolled in Medicare?

Yes. Tae Youn Kim is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Tae Youn Kim was last updated on March 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.