Individual provider Active NPI

Thaihang Nguyen, DO

  • Family Medicine Physician
  • Douglas, GA
National Provider Identifier
1053635078
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
069494 Issued in GA
Practice address
100 Doctors Dr Ste G
Douglas, GA 31533-2211
Phone
(912) 384-1477
Fax
(912) 389-1558
NPI assigned
Mar 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 069494 GA Primary

Addresses

Primary practice location

100 Doctors Dr Ste G
Douglas, GA 31533-2211

Mailing address

PO Box 1377
Douglas, GA 31534-1377
Phone (912) 384-1477

Other practice location 1

1101 Ocilla Rd
Douglas, GA 31533-2207
Phone (912) 384-1900

Other practice location 2

205 Shirley Ave
Douglas, GA 31533-2327
Phone (912) 383-6966

Other identifiers 2

IdentifierTypeStateIssuer
003135639AMedicaidGA
069494OtherGAMEDICAL LICENSE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130826000339 GA Practitioner - Family Practice 2163665092 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CRH Physician Practices, LLCGroup PAC ID 5193727964, 38 clinicians

Practice addresses (Care Compare)

100 Doctors Dr
Douglas, GA 31533-2211

1508 Tebeau St
Waycross, GA 31501-5327
Phone (912) 384-5832

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
CRH Physician Practices, LLC CurrentSince Oct 15, 2013 Accepting new patients
Coffee Emergency Group LLC CurrentSince May 20, 2016 Accepting new patients
CRH Physician Practices LLC Past Accepting new patients

Locations

205 Shirley Ave
Douglas, GA 31533
Phone (912) 260-5400

1101 Ocilla Rd
Douglas, GA 31533
Phone (912) 383-5641

100 Doctors Dr
Ste G
Douglas, GA 31533
Phone (912) 384-6186

1100 Ward Street Ext W
Douglas, GA 31533
Phone (912) 384-1470

1508 Tebeau St
Waycross, GA 31501
Phone (912) 383-6575

Interoperability endpoints

  • Direct secure messaging: thaihang.nguyen.1@9964.direct.athenahealth.com

Organizations & group practices 3

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1053635078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1377",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315341377",
            "telephone_number": "912-384-1477",
            "fax_number": "912-384-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DOCTORS DR STE G",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332211",
            "telephone_number": "912-384-1477",
            "fax_number": "912-389-1558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Ocilla Rd",
            "address_purpose": "LOCATION",
            "city": "Douglas",
            "state": "GA",
            "postal_code": "315332207",
            "country_code": "US",
            "telephone_number": "912-384-1900",
            "fax_number": "912-383-5667",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 Shirley Ave",
            "address_purpose": "LOCATION",
            "city": "Douglas",
            "state": "GA",
            "postal_code": "315332327",
            "country_code": "US",
            "telephone_number": "912-383-6966",
            "fax_number": "912-389-2108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THAIHANG",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "069494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003135639A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "069494",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, GA

Sources for this page

Verify at the official NPI Registry.