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Deactivated NPI 1154331114 Deactivated / Inactive NPI Female Practitioner

Dr. In Sook Kim , MD

General Practice • Bremen, GA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. In Kim has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 09, 2006
NPI Deactivation Date July 09, 2021
Total Practice Duration ~15 Years of Practice (2006 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. In Kim, MD was a registered General Practice practicing in Bremen, GA. Throughout an active medical career spanning 15 years, Dr. Kim provided care at the practice location at 201 ALLEN MEMORIAL DR until profile deactivation on 2021-07-09.

Historical Medicare Part B clinical services included established patient outpatient office visit, insertion of needle into vein for collection of blood sample, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

201 Allen Memorial Dr

Bremen, GA 301102011

Telephone 7705374818
Fax 7705376684
Associated Practice Facility / Clinic
🏢 Haralson Medical Clinic, Pc Facility NPI 1851300842

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Bremen, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 28.9 Yrs
Regional Practice Density
1 Specialists

Practicing in Bremen, GA (369 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
40.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
76 21 $130.00 $70.71
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
37 24 $160.00 $104.21
36415 Insertion of needle into vein for collection of blood sample
16 14 $10.00 $2.94

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License GA 16085

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Pyung Kim , MD

Family Medicine

NPI 1427067404

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated July 09, 2021

Record deactivated on July 09, 2021

NPI Profile Active May 07, 2008

NPI status registered as active in NPPES database

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Updated Practice Location May 07, 2008

Registered at 201 ALLEN MEMORIAL DR, BREMEN, GA 301102011 (Tel: 7705374818)

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Updated Business Mailing Address May 07, 2008

Registered at 201 ALLEN MEMORIAL DR, BREMEN, GA 30110 (Tel: 7705374818)

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Provider Name / Credentials Updated May 07, 2008

Recorded as IN KIM, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 07, 2008

General Practice (License #16085 in GA)

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Initial NPI Registration & Enumeration August 09, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1154331114
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 09, 2006
Last Update: May 07, 2008
Deactivation Date: July 09, 2021

Mailing Address

201 Allen Memorial Dr

Bremen, GA 30110

Phone: 7705374818

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.