Individual provider Active NPI

Victor W Chen, MD

  • Rheumatology Physician
  • Canton, GA
National Provider Identifier
1417950668
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
057589 Issued in GA
Practice address
460 Northside Cherokee Blvd Ste 300
Canton, GA 30115-8019
Phone
(770) 721-9630
Fax
(770) 721-9631
NPI assigned
May 23, 2005
Last updated
Mar 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 200401183 NC
Pulmonary Disease Physician 207RP1001X 057589 GA
Rheumatology Physician 207RR0500X 057589 GA Primary

Addresses

Primary practice location

460 Northside Cherokee Blvd Ste 300
Canton, GA 30115-8019

Mailing address

320 Hospital Rd
Canton, GA 30114-2432
Phone (770) 479-5535

Other identifiers 1

IdentifierTypeStateIssuer
89137V8MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address victorchen@mang.allscriptsdirect.net Direct

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
I20080811000138 GA Practitioner - RheumatologyPractitioner - Internal Medicine 4385613017 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3340 Paddock Pkwy
Suwanee, GA 30024-9119
Phone (678) 679-6210

3350 Paddocks Pkwy
Suwanee, GA 30024-9119
Phone (678) 474-9633

3380 Paddocks Pkwy
Suwanee, GA 30024-9119
Phone (678) 474-9633

460 Northside Cherokee Blvd
Suite 300
Canton, GA 30115-8019
Phone (770) 721-9630

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.89 of 100Reported as group
Quality
70.82
Promoting interoperability
78
Improvement activities
40
Cost
77.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200401183NCMDSpecialist
057589GAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates Professional Services, LLC Pulmonary Disease CurrentSince Jan 1, 2014 Accepting new patients
Northside Primary Care Professional Services, LLC CurrentSince Feb 1, 2026 Accepting new patients
Northside Primary Care Professional Services,LLC CurrentSince Feb 1, 2026 Accepting new patients

Locations

201 Hospital Rd
Canton, GA 30114
Phone (770) 479-1941

320 Hospital Rd
Canton, GA 30114
Phone (770) 479-5535

450 Northside Cherokee Blvd
Canton, GA 30115
Phone (770) 224-1000

460 Northside Cherokee Blvd
Ste 300
Canton, GA 30115
Phone (770) 721-9630

1400 Northside Forsyth Dr
Ste 250
Cumming, GA 30041
Phone (770) 889-7118

3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1417950668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 HOSPITAL RD",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142432",
            "telephone_number": "770-479-5535",
            "fax_number": "770-720-3294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 NORTHSIDE CHEROKEE BLVD STE 300",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158019",
            "telephone_number": "770-721-9630",
            "fax_number": "770-721-9631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "VICTOR",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "200401183",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "057589",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "GA",
            "license": "057589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89137V8",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "victorchen@mang.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "direct messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct edge",
            "address_1": "460 Northside Cherokee Blvd Ste 300",
            "city": "Canton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301158019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.