Duluth Family Practice LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DULUTH FAMILY PRACTICE LLC

Practice address

4470 Satellite Blvd
Suite 204
Duluth, GA 30096-8851

Phone

(770) 858-5983

Fax

(770) 858-5066

NPI assigned

Sep 20, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Liem CHI Ngo, MDNPI 1891950457

Title

Owner

Phone

(770) 858-5983

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15492/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Liem CHI Ngo, M.D.

  • Family Medicine Physician
  • Duluth, GA
  • NPI 1891950457
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1442707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442707200000",
    "number": "1730558735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4470 SATELLITE BLVD",
            "address_2": "SUITE 204",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300968851",
            "telephone_number": "770-858-5983",
            "fax_number": "770-858-5066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4470 SATELLITE BLVD",
            "address_2": "SUITE 204",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300968851",
            "telephone_number": "770-858-5983",
            "fax_number": "770-858-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DULUTH FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-20",
        "last_updated": "2015-09-20",
        "status": "A",
        "authorized_official_last_name": "NGO",
        "authorized_official_first_name": "LIEM",
        "authorized_official_middle_name": "CHI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-858-5983",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Duluth Medicine
• Duluth Pediatric Dentistry PC
• Duluth Pharmacy LLC (Duluth pharmacy)
• Dunamis Healthcare Services

• Family Medicine Physician in Duluth, GA
• Providers in Duluth, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.