Phuongtam Nguyen, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

83914 Issued in GA

Practice address

101 Quartz Dr Ste 103
Villa Rica, GA 30180-3255

Phone

(770) 812-3530

Fax

(770) 812-3531

NPI assigned

Apr 16, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Psychiatry

Education

Howard University College of Medicine, 2016

Medicare assignment

May accept Medicare assignment

Group practices

TMC-Behavioral Health of West GeorgiaGroup PAC ID 2163714635, 37 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• TMC-Behavioral Health of West Georgia

  dba Behavioral Health of West Georgia

  • Geriatric Psychiatry Physician
  • Villa Rica, GA
  • NPI 1356795462
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1460764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1053765057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4037 NW 86TH TER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326069277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 QUARTZ DR STE 103",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301803255",
            "telephone_number": "770-812-3530",
            "fax_number": "770-812-3531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4037 NW 86th Ter",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326069277",
            "country_code": "US",
            "telephone_number": "352-265-4357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PHUONGTAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-16",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "GA",
            "license": "83914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neighborhood Chiropractic & Wellness Center, LLC
• Abby Neighbors
• Hannah Nelson, PT, DPT
• Ewane Ngone, MD
• Amanda Kauffmann Nguyen, M.D.
• Nicole a. Ford DC Inc (Villa Rica Chiropractic Wellness Center)
• Celina Noble
• Ashley Norred Powell, LPC
• Northwest Georgia Oncology Centers, PC
• Shondalyn Norwood, PHARM. D.

• Child & Adolescent Psychiatry Physician in Villa Rica, GA
• Providers in Villa Rica, GA by specialty
• Child & Adolescent Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.