MARY M. KIM (NPI# 1902880123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902880123 |
| Entity Type | Individual |
| Full Name | MARY M. KIM |
| Credential | M.D. |
| Practice Address |
1624 Mars Hill Rd Suite B Watkinsville GA 30677-4813 |
| Practice Telephone | 7063101030 |
| Practice Fax Number | 7067051444 |
| Mailing Telephone | 7063101030 |
| Mailing Fax Number | 7067051444 |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2011-08-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 050031 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00904142A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053729467 | Mary Grace Kim | Dentist | 8321 W Golf Rd, Niles, IL 60714-1113 | 2014-07-29 |
| 1568581536 | Mary M. Kim | Optometrist | 978 Main St., S. Weymouth, MA 02190 | 2007-03-28 |
| 1497301261 | Mary Suhyun Kim | Student in an Organized Health Care Education/Training Program | 3800 Reservoir Rd Nw, Washington, DC 20007-2113 | 2019-08-16 |
| 1861975344 | Mary Kim | Registered Nurse | 6223 N Canton Center Rd Ste 201, Canton, MI 48187-2696 | 2018-09-11 |
| 1184165516 | Mary Kim | Dentist | 251 E Huron St, Chicago, IL 60611-2908 | 2017-03-18 |
| 1730523309 | Mary E Kim | Dermatology | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2013-04-25 |
| 1275720930 | Mary Kim | Physician Assistant | 4502 Medical Dr, San Antonio, TX 78229-4402 | 2007-09-26 |
| 1790804060 | Mary Wai Ming Kim | Dentist | 1441 Kapiolani Blvd, Suite 1515, Honolulu, HI 96814 | 2007-03-28 |
| 1508998782 | Mary Ann Kim | Dentist | 233 S Wacker Dr, Lower Level 1, Chicago, IL 60606-6306 | 2007-03-12 |
| 1780724435 | Mary I Kim | Physical Medicine & Rehabilitation | 11406 Loma Linda Dr, Suite 516, Loma Linda, CA 92354-3711 | 2007-02-08 |
| Street Address |
1624 MARS HILL RD SUITE B |
| City | WATKINSVILLE |
| State | GA |
| Zip Code | 30677-4813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275916629 | Ruth Quicke Brown | Nurse Practitioner | 1624 Mars Hill Rd, Suite B, Watkinsville, GA 30677-4813 | 2015-07-02 |
| 1275860900 | Oconee Primary Care, L.L.C. | Internal Medicine | 1624 Mars Hill Rd, Suite B, Watkinsville, GA 30677-4813 | 2009-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669071478 | Brenda Gerai James | Behavior Technician | 1272 Virgil Langford Rd, Ste 101, Watkinsville, GA 30677 | 2020-10-22 |
| 1881292597 | Chloe Wise | Specialist/Technologist | 360 Caduceus Way Building 600 - Suite 101., Watkinsville, GA 30677 | 2020-10-14 |
| 1912518531 | Samuel S Kwon - Athens Dmd PC | Dentist | 1795 Resurgence Drive, Suite 101, Watkinsville, GA 30677 | 2020-08-17 |
| 1972131977 | Hopebridge LLC | Behavioral Analyst | 1272 Virgil Langford Road, Suite 101, Watkinsville, GA 30677 | 2020-03-27 |
| 1306479068 | Meggan Brittany Reed | Counselor | 1550 Jennings Mill Rd, Suite 1700b, Watkinsville, GA 30677 | 2020-02-20 |
| 1699322040 | Christopher's Bridge, LLC | In Home Supportive Care | 3651 Mars Hill Rd, Suite 1600, Watkinsville, GA 30677 | 2019-08-21 |
| 1093209538 | Haley Bauguss | Physician Assistant | 1624 Mars Hill Road, Suite B, Watkinsville, GA 30677 | 2018-06-19 |
| 1134618317 | Amanda Burns Denson | Nurse Practitioner | 1181 Langford Drive, Building 300, Suite 104, Watkinsville, GA 30677 | 2018-05-03 |
| 1780105528 | Inspiring Hospice Partners of Georgia LLC | Hospice Care, Community Based | 1252 Virgil Langford Rd, Watkinsville, GA 30677 | 2017-07-01 |
| 1750753182 | Zachary Russell | Orthopaedic Surgery | 1305 Jennings Mill Road, Building 300, Suite 110, Watkinsville, GA 30677 | 2015-10-26 |
| Find all providers in zip 30677 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306395520 | Aliya Safwan | Internal Medicine | 1305 Jennings Mill Rd Bldg A, Watkinsville, GA 30677-7238 | 2016-09-29 |
| 1629416946 | Christopher Curtis Whalen | Internal Medicine | 1501 Hickory Hill Dr, Watkinsville, GA 30677-2187 | 2013-06-09 |
| 1447693056 | Falahat Ali Farooqui | Internal Medicine | 1800 Hog Mountain Rd Bldg 200-103, Watkinsville, GA 30677-1950 | 2013-04-12 |
| 1336458827 | Dr. Jana L Mckenzie Md PC | Internal Medicine | 2410 Hog Mountain Rd Ste 205, Watkinsville, GA 30677-4850 | 2010-09-30 |
| 1811150477 | Kelly Lynn Overman | Internal Medicine | 1336 Prince Pl, Watkinsville, GA 30677-7979 | 2008-07-03 |
| 1538128269 | William E Rigsby | Internal Medicine | 1800 Hog Mountain Rd, Bldg 600 Suite 103, Watkinsville, GA 30677 | 2006-03-21 |
| 1285693911 | Felicia S Lacksen | Internal Medicine | 1351 Stonebridge Pkwy, Bldg 105, Watkinsville, GA 30677-6037 | 2006-03-21 |
| 1245214402 | Ken H. Park | Internal Medicine | 1624 Mars Hill Rd Ste B, Watkinsville, GA 30677-4813 | 2005-12-01 |
| 1912988288 | Michelle H Woodard | Internal Medicine | 2410 Hog Mountain Rd. Ste. 303, Watkinsville, GA 30677 | 2005-11-14 |
| 1760023121 | Greater Atlanta Md Inc | Internal Medicine | 1800 Hog Mountain Rd, Bldg 200 Ste 103, Watkinsville, GA 30677 | 2019-10-07 |
| Find all providers in WATKINSVILLE | ||||
| City | WATKINSVILLE |
| Zip Code | 30677 |
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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.