Individual provider Active NPI

Jacqueline Nguyen, D.O.

  • Family Medicine Physician
  • Atlanta, GA
National Provider Identifier
1063891372
Registry record updated Jul 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
80164 Issued in GA
Practice address
1125 Norwich Cir NE
Atlanta, GA 30324
Phone
(404) 655-5244
NPI assigned
May 20, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2018

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 80164 GA Primary

Addresses

Primary practice location

1125 Norwich Cir NE
Atlanta, GA 30324

Mailing address

1125 Norwich Cir NE
Atlanta, GA 30324-2900
Phone (404) 655-5244

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
I20181022001335 GA Practitioner - Family Practice 8022361054 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

1155 Concord Rd SE
Suite 200
Smyrna, GA 30080-4255
Phone (678) 600-5137

2292 Peachtree Rd
Atlanta, GA 30309-1147
Phone (404) 382-9941

2520 N Decatur Rd
Decatur, GA 30033-6117
Phone (678) 685-8100

2810 Paces Ferry Rd SE
Suite 156
Atlanta, GA 30339-5700
Phone (470) 750-1301

3617 Roswell Nerd a
Atlanta, GA 30305-1111
Phone (404) 996-0196

749 Lanier Ave W
Suite 1850
Fayetteville, GA 30214-7658
Phone (770) 835-4925

882 Ponce de Leon Ave
Atlanta, GA 30306-4268
Phone (770) 809-3034

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
80164GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstreet of Georgia PC CurrentSince Nov 1, 2020 Accepting new patients

Locations

2292 Peachtree Rd NW
Atlanta, GA 30309
Phone (404) 382-9941

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532131200000",
    "number": "1063891372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 NORWICH CIR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303242900",
            "telephone_number": "404-655-5244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 NORWICH CIR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30324",
            "telephone_number": "404-655-5244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JACQUELINE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-20",
        "last_updated": "2018-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "80164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.