Active NPI
Hung Thien Ly, M.D.
- General Practice Physician
- Pooler, GA
National Provider Identifier
1639296569
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(4) exclusion effective Mar 18, 2010.
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- GA047797
- Practice address
- 1393 US Highway 80 E
Pooler, GA 31322-8901 - Phone
- (912) 964-0108
- NPI assigned
- Mar 24, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | GA047797 | GA | Primary |
Addresses
Primary practice location
1393 US Highway 80 E
Pooler, GA 31322-8901
Mailing address
PO Box 31096
Savannah, GA 31410-8196
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| GA047797 | GA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639296569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31096",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314108196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1393 US HIGHWAY 80 E",
"city": "POOLER",
"state": "GA",
"postal_code": "313228901",
"telephone_number": "912-964-0108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LY",
"first_name": "HUNG",
"middle_name": "THIEN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "GA",
"license": "GA047797",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pooler, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.