NPIMap

Individual provider Active NPI

Ven Chung Chiang, MD

  • Nephrology Physician
  • Valdosta, GA
National Provider Identifier
1447367453
Registry record updated Apr 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
054594 Issued in GA
Practice address
410 Cowart Ave
Valdosta, GA 31602-2622
Phone
(229) 244-6544
Fax
(229) 241-9744
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 054594 GA Primary

Addresses

Primary practice location

410 Cowart Ave
Valdosta, GA 31602-2622

Mailing address

P.O. Box 2267
Valdosta, GA 31604
Phone (229) 244-6544

Other identifiers 1

IdentifierTypeStateIssuer
843869286AMedicaidGA

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
I20041008000441 GA Practitioner - NephrologyPractitioner - Internal Medicine 1850350448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

410 Cowart Ave
Valdosta, GA 31602-2622
Phone (229) 244-6544

Hospital & facility affiliations

  • FMC - Valdosta Dialysis Clinic Dialysis facility, Valdosta, GA, CCN 112773
  • DaVita Oak Street Dialysis Dialysis facility, Valdosta, GA, CCN 112515
  • SGMC Health Hospital, Valdosta, GA, CCN 110122
  • SGMC Berrien Campus Hospital, Nashville, GA, CCN 110234
  • Madison County Memorial Hospital Hospital, Madison, FL, CCN 101311
  • SGMC Health Lanier Hospital, Lakeland, GA, CCN 111326

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
054594GAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valdosta Kidney Clinic, LLC CurrentSince May 20, 2004 Accepting new patients
Lourdes Hospital LLC Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Sleep Solutions, Inc. Past Accepting new patients

Locations

410 Cowart Ave
Valdosta, GA 31602
Phone (229) 244-6544

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JGACDD/Endpoint/JGACDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/JGACDD

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 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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333929600000",
    "number": "1447367453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2267",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31604",
            "telephone_number": "229-244-6544",
            "fax_number": "229-241-9744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 COWART AVE",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022622",
            "telephone_number": "229-244-6544",
            "fax_number": "229-241-9744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIANG",
        "first_name": "VEN",
        "middle_name": "CHUNG",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2012-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "054594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "843869286A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.