Active NPI
Andy Nguyen
- Physician Assistant
- Atlanta, GA
National Provider Identifier
1073390720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 13000
- Practice address
- 1100 Johnson Fy Rd NE Ste 350
Atlanta, GA 30342-1740 - Phone
- (404) 851-6051
- Fax
- (404) 845-5356
- NPI assigned
- Sep 14, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 13000 | GA | Primary |
Addresses
Primary practice location
1100 Johnson Fy Rd NE Ste 350
Atlanta, GA 30342-1740
Mailing address
3957 Jody LN
Lilburn, GA 30047-8038
Phone (404) 488-8273
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743638400000",
"number": "1073390720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3957 JODY LN",
"city": "LILBURN",
"state": "GA",
"postal_code": "300478038",
"telephone_number": "404-488-8273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 JOHNSON FY RD NE STE 350",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303421740",
"telephone_number": "404-851-6051",
"fax_number": "404-845-5356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "ANDY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-09-14",
"last_updated": "2025-04-03",
"certification_date": "2025-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "13000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.