DR. KYOUNG-SOON KIM (NPI# 1760473276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760473276 |
| Entity Type | Individual |
| Full Name | DR. KYOUNG-SOON KIM |
| Other Name | DR. BOB KIM |
| Credential | MD |
| Practice Address |
1770 Dennis Kemp Ln Nw Kennesaw GA 30152-3938 |
| Practice Telephone | 7705159000 |
| Practice Fax Number | 6788133355 |
| Mailing Telephone | 7705159000 |
| Mailing Fax Number | 6788133355 |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2016-08-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 039144 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
1770 DENNIS KEMP LN NW |
| City | KENNESAW |
| State | GA |
| Zip Code | 30152-3938 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255980926 | Jamie Marie Conwell | Nurse Practitioner | 1770 Dennis Kemp Ln Nw, Kennesaw, GA 30152-3938 | 2019-09-05 |
| 1841799905 | Hilere Welch Pasley | Registered Nurse | 1770 Dennis Kemp Ln Nw, Kennesaw, GA 30152-3938 | 2018-02-05 |
| 1477939676 | Stepping Stone Pediatrics, LLC | Clinic/Center | 1770 Dennis Kemp Ln Nw, Kennesaw, GA 30152-3938 | 2015-08-11 |
| 1013001973 | Tanya S Wilcox | Nurse Practitioner | 1770 Dennis Kemp Ln Nw, Kennesaw, GA 30152-3938 | 2006-10-03 |
| 1164490504 | Mary Elizabeth Graves | Nurse Practitioner | 1770 Dennis Kemp Ln Nw, Kennesaw, GA 30152-3938 | 2006-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821647124 | Ashley Dover | Nurse Practitioner | 1300 Ridenour Blvd, Suite 300, Kennesaw, GA 30152 | 2019-09-09 |
| 1205306891 | Lashanda Denise Moore | Nurse Practitioner | 1600 Kennesaw Due West Rd Nw #205, Kennesaw, GA 30152 | 2018-11-27 |
| 1265901094 | Focused Loving Home Care Services LLC | In Home Supportive Care | 2151 Marne Glen Nw, Kennesaw, GA 30152 | 2018-11-22 |
| 1083199152 | Raven Ashley Thomas | Behavioral Analyst | 1619 Collins Rd Nw Ste 500, Kennesaw, GA 30152 | 2018-09-25 |
| 1821592593 | Eseovhe Egborge PC | Clinic/Center | 1600 Kennesaw Due West Rd Nw Ste 205, Kennesaw, GA 30152 | 2018-03-19 |
| 1184143059 | Kennesaw Mountain Dental Associates | Dentist | 1815 Old 41 Hwy, Ste 310, Kennesaw, GA 30152 | 2017-09-12 |
| 1265955983 | Deborah Ruth Stern Compton | Registered Nurse | 1291 Stanley Rd., Kennesaw, GA 30152 | 2017-07-25 |
| 1912452939 | Mak Anesthesia Holdings LLC | Anesthesiology | 1300 Ridenour Blvd., Ste. 300, Kennesaw, GA 30152 | 2016-08-19 |
| 1528430279 | Tineka Nichol Wyckoff | Counselor | 1967 Lake Heights Circle, Kennesaw, GA 30152 | 2015-10-21 |
| 1669753992 | American Current Care Pa | Clinic/Center | 2953 Cobb Parkway, Suite 400, Kennesaw, GA 30152 | 2011-08-31 |
| Find all providers in zip 30152 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649685728 | Lum Frundi | Pediatrics | 3150 Cobb Pkwy Nw Ste 130, Kennesaw, GA 30152-1007 | 2014-06-26 |
| 1972892255 | Jeffrey Sacks | Pediatrics | 1180 Ernest W Barrett Pkwy Nw Ste 102a, Kennesaw, GA 30144-4534 | 2011-04-07 |
| 1558599084 | Saudiqa Hoossainy | Pediatrics | 5150 Stilesboro Rd., Suite 220, Wellstar Pediatrics At Brookstone, Kennesaw, GA 30152 | 2009-06-23 |
| 1861628141 | Tashawna Thomas Stokes | Pediatrics | 3745 Cherokee St Nw Ste 401, Kennesaw, GA 30144-6787 | 2009-06-01 |
| 1003010976 | Brandi Lewis | Pediatrics | 1180 Ernest W Barrett Pkwy Nw Ste 102b, Kennesaw, GA 30144 | 2007-06-13 |
| 1043320872 | Anabelle Monroe | Pediatrics | Pediatrics Health Care Team A, 750 Townpark Lane, Kennesaw, GA 30144 | 2006-08-30 |
| 1326064007 | Regina Frances Robbins | Pediatrics | 1180 Ernest W Barrett Pkwy Nw, Wellstar Medical Group LLC, Kennesaw, GA 30144-4534 | 2006-07-14 |
| 1588620736 | Briana I Brugner | Pediatrics | 3745 Cherokee St, Ste 401, Kennesaw, GA 30144 | 2006-04-25 |
| 1003870577 | Krishna V Eechampati | Pediatrics | 2985 George Busbee Pkwy Nw, Kennesaw, GA 30144-6812 | 2006-04-13 |
| 1851382840 | Jeffrey H Hasty | Pediatrics | 205 Hawkins Store Rd, Suite B 1, Kennesaw, GA 30144 | 2005-10-31 |
| Find all providers in KENNESAW | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.