Individual provider Active NPI

Tong Wang

  • Nurse Practitioner
  • Norcross, GA
National Provider Identifier
1023899853
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN211617 Issued in GA
Practice address
777 W Peachtree St
Norcross, GA 30071-1868
Phone
(770) 246-6100
NPI assigned
Oct 9, 2023
Last updated
Sep 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN211617 GA Primary

Addresses

Primary practice location

777 W Peachtree St
Norcross, GA 30071-1868

Mailing address

3860 Seaton Dr
Suwanee, GA 30024-6658
Phone (678) 865-9663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250402001732 GA Practitioner - Nurse Practitioner 1355864125 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Comfort Medical LLC CurrentSince Apr 1, 2025 Accepting new patients
Magnolia Comfort Medical South LLC Nurse Practitioner CurrentSince Feb 1, 2025 Accepting new patients
The Emory Clinic Inc CurrentSince Oct 21, 2025 Accepting new patients
Sage Health at Home LLC Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

7193 Jonesboro Rd
Ste 101102
Morrow, GA 30260
Phone (470) 726-1699

6050 Peachtree Pkwy
Ste 420
Peachtree Corners, GA 30092
Phone (470) 726-1699

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1023899853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 SEATON DR",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246658",
            "telephone_number": "678-865-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 W PEACHTREE ST",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300711868",
            "telephone_number": "770-246-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "TONG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-09",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN211617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

Verify at the official NPI Registry.