NPIMap

Individual provider Active NPI

Tung Van Nguyen, DO

  • Family Medicine Physician
  • Mableton, GA
National Provider Identifier
1245248103
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
44802 Issued in GA
Practice address
657 Vinings Estates Dr SE
Mableton, GA 30126
Phone
(404) 274-5182
Fax
(678) 398-5442
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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 44802 GA Primary

Addresses

Primary practice location

657 Vinings Estates Dr SE
Mableton, GA 30126

Mailing address

1790 Mulkey Rd
Ste. 8
Austell, GA 30106-1122
Phone (770) 944-1830

Other practice location 1

1790 Mulkey Rd Ste 8A
Austell, GA 30106-1122
Phone (770) 944-1830

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tnguyen23218@directwellstar.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041018000665 GA Practitioner - Family Practice 6800856451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1790 Mulkey Rd
Austell, GA 30106-1122

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44802GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Family Medicine CurrentSince Mar 1, 2011 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Mar 1, 2011 Accepting new patients
Springs Health LLC PastSince Dec 22, 2024 Accepting new patients
Open Door Health Services, Inc. Past Accepting new patients
Peachstreet Immediate Care Center Family Medicine Past Accepting new patients

Locations

1790 Mulkey Rd
Ste 8
Austell, GA 30106
Phone (770) 944-1830

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

Interoperability endpoints

  • Direct secure messaging: tnguyen23218@directwellstar.org

Organizations & group practices 5

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 6

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1245248103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 MULKEY RD",
            "address_2": "STE. 8",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061122",
            "telephone_number": "770-944-1830",
            "fax_number": "770-739-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 VININGS ESTATES DR SE",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "30126",
            "telephone_number": "404-274-5182",
            "fax_number": "678-398-5442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1790 Mulkey Rd Ste 8A",
            "address_purpose": "LOCATION",
            "city": "Austell",
            "state": "GA",
            "postal_code": "301061122",
            "country_code": "US",
            "telephone_number": "770-944-1830",
            "fax_number": "770-739-0260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TUNG",
        "middle_name": "VAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "44802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tnguyen23218@directwellstar.org",
            "affiliation": "N",
            "address_1": "1790 Mulkey Rd Ste 8A",
            "city": "Austell",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301061122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mableton, GA

Sources for this page

Verify at the official NPI Registry.