Individual provider Active NPI

Regina Jianhua Wang, M.D.

  • Family Medicine Physician
  • Duluth, GA
National Provider Identifier
1073504643
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
050568 Issued in GA
Practice address
3814 Satellite Blvd Ste 100
Duluth, GA 30096-5693
Phone
(770) 514-8880
Fax
(678) 648-1788
NPI assigned
Nov 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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 050568 GA Primary

Addresses

Primary practice location

3814 Satellite Blvd Ste 100
Duluth, GA 30096-5693

Mailing address

3814 Satellite Blvd Ste 100
Duluth, GA 30096-5693
Phone (770) 514-8880

Other identifiers 2

IdentifierTypeStateIssuer
00951475BMedicaidGA
00951475AMedicaidGA

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
I20091111000222 GA Practitioner - Family Practice 6103964242 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4720 Peachtree Industrial Blvd
Suite 202
Berkeley Lake, GA 30071-5736
Phone (770) 514-8880

Hospital & facility affiliations

  • Northside Hospital Duluth Hospital, Duluth, GA, CCN 110252
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
  • Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
  • Emory Johns Creek Hospital Hospital, Johns Creek, GA, CCN 110230

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Family Practice P.C CurrentSince Oct 29, 2012 Accepting new patients
Emory Specialty Associates, LLC Family Medicine Past Accepting new patients
Johns Creek Family Physicians, LLC Family Medicine Past Accepting new patients

Locations

4720 Peachtree Industrial Blvd
Ste 202
Berkeley Lake, GA 30071
Phone (770) 454-9047

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 5

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1073504643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3814 SATELLITE BLVD STE 100",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965693",
            "telephone_number": "770-514-8880",
            "fax_number": "678-648-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3814 SATELLITE BLVD STE 100",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965693",
            "telephone_number": "770-514-8880",
            "fax_number": "678-648-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "REGINA",
        "middle_name": "JIANHUA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "050568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00951475B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00951475A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.