Individual provider Active NPI

Thi Minh Diem Nguyen, MD

  • Family Medicine Physician
  • Austell, GA
National Provider Identifier
1629089354
Registry record updated Oct 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
51697 Issued in GA
Practice address
4426 Austell Rd
Austell, GA 30106-1844
Phone
(678) 398-5440
Fax
(678) 398-5442
NPI assigned
Aug 10, 2006
Last updated
Oct 27, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2008

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 51697 GA Primary

Addresses

Primary practice location

4426 Austell Rd
Austell, GA 30106-1844

Mailing address

4426 Austell Rd
Austell, GA 30106-1844
Phone (678) 398-5440

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
I20041018000614 GA Practitioner - Family Practice 6406816032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

2450 Old Milton Pkwy
Alpharetta, GA 30009-2520

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51697GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Family Medicine Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Dec 1, 2013 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Dec 1, 2013 Accepting new patients
Peachstreet Immediate Care Center Family Medicine PastSince Jun 1, 2004 Accepting new patients
Springs Health LLC PastSince Dec 22, 2024 Accepting new patients

Locations

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

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

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

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225065600000",
    "number": "1629089354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4426 AUSTELL RD",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061844",
            "telephone_number": "678-398-5440",
            "fax_number": "678-398-5442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4426 AUSTELL RD",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061844",
            "telephone_number": "678-398-5440",
            "fax_number": "678-398-5442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THI MINH",
        "middle_name": "DIEM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2008-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "51697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.