MRS. JIYEON KIM PA
NPI 1154863520
Nurse Practitioner - Family in Duluth, GA

Q: What is Jiyeon Kim's NPI number?

The NPI number for Jiyeon Kim is 1154863520. It was assigned to this individual provider in the NPPES registry on November 16, 2016.

Q: What is Jiyeon Kim's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Jiyeon Kim was last updated on November 16, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.

Active since November 16, 2016PECOS Enrolled

3610 PEACHTREE INDUSTRIAL BLVD, SUITE 100, DULUTH, GA 30096(678) 417-0332(470) 200-2823 Get Directions Write a Review

NPPES record last updated: November 16, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mrs. Jiyeon Kim Pa NPPES

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

MRS. JIYEON KIM PA (NPI 1154863520) is an individual family provider in Duluth, Georgia, licensed in Georgia (F0317639) and active in the NPI registry since November 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154863520

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMRS. JIYEON KIMCredential: PA

Location Address3610 PEACHTREE INDUSTRIAL BLVD, SUITE 100Duluth, GA 30096-4953

Mailing Address3610 Peachtree Industrial Blvd, Suite 100Duluth, GA 30096-4953 · (678) 417-0332 · Fax (470) 200-2823

Phone(678) 417-0332

Fax(470) 200-2823

Sole ProprietorNo

Enumeration DateNovember 16, 2016

✔ NPI 1154863520 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in GA · F0317639

Also ListedNurse PractitionerTaxonomy 363L00000X · License F0317639 (GA)

3610 PEACHTREE INDUSTRIAL BLVD, Duluth, GA 30096

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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)

Mrs. Jiyeon Kim Pa 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30096 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

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

DR. KONJIT ZENA PHARMD

Pharmacist

3610 PEACHTREE INDUSTRIAL BLVD
DULUTH, GA 30096

Gwinnett County (770) 476-7442

JINA Y. KIM MD

Family Medicine

3610 PEACHTREE INDUSTRIAL BLVD, SUITE 100
DULUTH, GA 30096

Gwinnett County (678) 417-0332

DREAM PHARMACY INC

Pharmacy

3610 PEACHTREE INDUSTRIAL BLVD, STE 400
DULUTH, GA 30096

Gwinnett County (770) 299-1971

MRS. MANISHA S JOSHI

Pharmacist

3610 PEACHTREE INDUSTRIAL BLVD
DULUTH, GA 30096

Gwinnett County (770) 476-7442

DREAM PHARMACY, INC.

Pharmacy

3610 PEACHTREE INDUSTRIAL BLVD, STE 400
DULUTH, GA 30096

Gwinnett County (770) 299-1971

MR. BADRINATH JAYANTHI

Pharmacist

3610 PEACHTREE INDUSTRIAL BLVD
DULUTH, GA 30096

Gwinnett County (678) 462-6766

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 Jiyeon Kim's NPI number?

The NPI number for Jiyeon Kim is 1154863520. It was assigned to this individual provider in the NPPES registry on November 16, 2016.

Where is Jiyeon Kim located?

Jiyeon Kim practices at 3610 Peachtree Industrial Blvd Suite 100, Duluth, GA 30096. The listed phone number is (678) 417-0332.

What is Jiyeon Kim's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Jiyeon Kim enrolled in Medicare?

Yes. Jiyeon Kim is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jiyeon Kim was last updated on November 16, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.