Individual provider Active NPI

Sophie Thanh Nguyen

  • Family Nurse Practitioner
  • Morrow, GA
National Provider Identifier
1497017016
Registry record updated Jun 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN184991 Issued in GA
Practice address
1159 Reynolds CT
Morrow, GA 30260-1043
Phone
(678) 799-1136
NPI assigned
Jun 10, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN184991 GA Primary

Addresses

Primary practice location

1159 Reynolds CT
Morrow, GA 30260-1043

Mailing address

1159 Reynolds CT
Morrow, GA 30260-1043
Phone (678) 799-1136

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
I20191024000603 GA Practitioner - Nurse Practitioner 8628300639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
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)

145 N Medical Pkwy
Woodstock, GA 30189-7031
Phone (770) 592-3000

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Oct 1, 2021 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Oct 1, 2021 Accepting new patients
Douglas County Family Practice, P.C. CurrentSince Sep 1, 2019 Accepting new patients
Douglas County Family Practice, P.C. PastSince Sep 1, 2019 Accepting new patients

Locations

3872 Highway 5
Douglasville, GA 30135
Phone (770) 949-5534

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

145 N Medical Pkwy
Woodstock, GA 30189
Phone (770) 517-1900

Interoperability endpoints

  • Direct secure messaging: snguyen432716@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.

NPI Registry JSON

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

{
    "created_epoch": "1339286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339286400000",
    "number": "1497017016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1159 REYNOLDS CT",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302601043",
            "telephone_number": "678-799-1136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1159 REYNOLDS CT",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302601043",
            "telephone_number": "678-799-1136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "SOPHIE",
        "middle_name": "THANH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-10",
        "last_updated": "2012-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN184991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrow, GA

Sources for this page

Verify at the official NPI Registry.