Individual provider Active NPI

Courtney Thi Nguyen

  • Physician Assistant
  • Alpharetta, GA
National Provider Identifier
1174251573
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11895 Issued in NU
Practice address
1539 Park Woods Cir
Ste 603
Alpharetta, GA 30005-3000
Phone
(678) 615-7032
NPI assigned
Aug 12, 2022
Last updated
Nov 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11895 NU Primary

Addresses

Primary practice location

1539 Park Woods Cir
Ste 603
Alpharetta, GA 30005-3000

Mailing address

11539 Park Woods Cir Ste 603
Alpharetta, GA 30005-2413
Phone (678) 615-7032

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240719002010 GA Practitioner - Physician Assistant 8325584998 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
MHD Anas Alkhatib LLC PastSince Nov 12, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: courtney.nguyen.1@25899.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1174251573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11539 PARK WOODS CIR STE 603",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300052413",
            "telephone_number": "678-615-7032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1539 PARK WOODS CIR",
            "address_2": "STE 603",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300053000",
            "telephone_number": "678-615-7032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "COURTNEY",
        "middle_name": "THI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-12",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": "11895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.