Individual provider Active NPI

Tania Lugo, MD

  • Obstetrics & Gynecology Physician
  • Duluth, GA
National Provider Identifier
1477080158
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
89819 Issued in GA
Practice address
2200 Duluth Highway 120 Apt 4007
Duluth, GA 30097-4156
Phone
(706) 414-2502
NPI assigned
May 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 89819 GA Primary

Addresses

Primary practice location

2200 Duluth Highway 120 Apt 4007
Duluth, GA 30097-4156

Mailing address

2200 Duluth Highway 120 Apt 4007
Duluth, GA 30097-4156
Phone (706) 414-2502

Other practice location 1

541 Historic Highway 441 North
Demorest, GA 30535-4528
Phone (706) 839-4000

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
I20240709004146 GA Practitioner - Obstetrics/Gynecology 5395082713 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc CurrentSince Jun 20, 2024 Accepting new patients
DHP of Piedmont PC Obstetrics & Gynecology CurrentSince Sep 1, 2024 Accepting new patients
Fayette Community Hospital, Inc. Past Accepting new patients

Locations

541 441 Historic Hwy N
Demorest, GA 30535
Phone (706) 839-4000

1255 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-6911

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1477080158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 DULUTH HIGHWAY 120 APT 4007",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300974156",
            "telephone_number": "706-414-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 DULUTH HIGHWAY 120 APT 4007",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300974156",
            "telephone_number": "706-414-2502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "541 Historic Highway 441 North",
            "address_purpose": "LOCATION",
            "city": "Demorest",
            "state": "GA",
            "postal_code": "305354528",
            "country_code": "US",
            "telephone_number": "706-839-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUGO",
        "first_name": "TANIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-12",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "89819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.