AG FAMILY MEDICINE, PC
NPI 1174783435
Clinic/Center - Primary Care in Duluth, GA
About Ag Family Medicine, Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AG FAMILY MEDICINE, PC (NPI 1174783435) is a healthcare organization registered as a primary care in Duluth, Georgia and active in the NPI registry since June 2008. The organization holds a CLIA Waiver certificate valid through October 22, 2027 and lists Chang Soo Kim, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ag Family Medicine, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Ag Family Medicine, PC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 11D2067820
Ag Family Medicine, PC · Duluth, GAFrequently 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 Ag Family Medicine, PC's NPI number?
The NPI number for Ag Family Medicine, PC is 1174783435. It was assigned to this organization in the NPPES registry on June 11, 2008.
Where is Ag Family Medicine, PC located?
Ag Family Medicine, PC is located at 3590 Peachtree Industrial Blvd, Duluth, GA 30096. The listed phone number is (770) 614-9799.
What is Ag Family Medicine, PC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Ag Family Medicine, PC enrolled in Medicare?
Yes. Ag Family Medicine, PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Ag Family Medicine, PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Ag Family Medicine, PC, in Family Practice and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Ag Family Medicine, PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 11D2067820) is associated with this NPI, valid through October 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Ag Family Medicine, PC accept?
Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Ag Family Medicine, PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Ag Family Medicine, PC was last updated on December 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Ag Family Medicine, Pc · NPI 1174783435
Primary Care organization in Duluth, Georgia. Organization record, active in the CMS NPPES registry since June 11, 2008.
## Identity
- **NPI:** 1174783435 (Entity type: Organization)
- **Enumerated:** June 11, 2008
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Chang Soo Kim, PRESIDENT
## Practice location
- **Address:** 3590 PEACHTREE INDUSTRIAL BLVD, Duluth, GA 30096-4817
- **Phone:** (770) 614-9799 · **Fax:** (770) 614-9789
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (2), Family Practice (1); 1 practice at this address and 2 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 15, 2025
- **Other identifiers:** Medicaid 868452174A (GA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1174783435) · Data from the CMS NPPES public registry.