Individual provider Active NPI

Cang Trung Nguyen, DO

  • Otolaryngology/Facial Plastic Surgery Physician
  • Douglasville, GA
National Provider Identifier
1154860518
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
109366 Issued in GA
Practice address
6130 Prestley Mill Rd Ste C
Douglasville, GA 30134-2288
Phone
(678) 838-3903
NPI assigned
Feb 17, 2017
Last updated
Aug 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X DO.2946 AL
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 109366 GA Primary

Addresses

Primary practice location

6130 Prestley Mill Rd Ste C
Douglasville, GA 30134-2288

Mailing address

11660 Woodrun Dr
Strongsville, OH 44136-3797

Other practice location 1

2055 E South Blvd Ste 908
Montgomery, AL 36116-2007
Phone (334) 747-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220714001508 AL Practitioner - Otolaryngology 3971878711 Reassigns benefits to 1 organization
I20251008001633 GA Practitioner - Otolaryngology 3971878711 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians
Ear, Nose and Throat Plastic Surgery CenterGroup PAC ID 2961497318, 4 clinicians

Practice addresses (Care Compare)

1668 Mulkey Rd
Suite E
Austell, GA 30106-1163
Phone (678) 838-3903

2055 E S Blvd
Suite 908
Montgomery, AL 36116-2007
Phone (334) 747-7500

6130 Prestley Mill Rd
Suite C
Douglasville, GA 30134-2288
Phone (678) 838-3903

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83 of 100Reported as group
Quality
64.43
Promoting interoperability
100
Improvement activities
40
Cost
78.9

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision19
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
109366GAMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Sep 1, 2022 Accepting new patients
Northside Surgical Professional Services LLC CurrentSince Sep 23, 2025 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Sep 1, 2022 Accepting new patients
Ear, Nose & Throat Plastic Surgery Center Otolaryngology/Facial Plastic Surgery CurrentSince Nov 1, 2025 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Current Accepting new patients
The Health Care Authority for Baptist Health Past Accepting new patients
The Health Care Authority for Baptist Health Past Accepting new patients

Locations

2055 E South Blvd
Ste 200
Montgomery, AL 36116
Phone (334) 284-5211

2055 E South Blvd
Ste 308
Montgomery, AL 36116
Phone (334) 286-2390

2055 E South Blvd
Ste 908
Montgomery, AL 36116
Phone (334) 284-6500

301 Brown Springs Rd
Montgomery, AL 36117
Phone (334) 273-4159

1668 Mulkey Rd
Ste E
Austell, GA 30106
Phone (616) 308-0062

6130 Prestley Mill Rd
Ste C
Douglasville, GA 30134
Phone (678) 838-3903

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

Organizations & group practices 7

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

Hospital & facility affiliations 2

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": "1487289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1154860518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11660 WOODRUN DR",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441363797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6130 PRESTLEY MILL RD STE C",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342288",
            "telephone_number": "678-838-3903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2055 E South Blvd Ste 908",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "AL",
            "postal_code": "361162007",
            "country_code": "US",
            "telephone_number": "334-747-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CANG",
        "middle_name": "TRUNG",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-17",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "AL",
            "license": "DO.2946",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "GA",
            "license": "109366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.