Jacky Thuvan Duong, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

5101014969 Issued in MI

Practice address

420 S Saginaw St
Flint, MI 48502-1803

Phone

(810) 232-3522

Fax

(810) 762-4494

NPI assigned

Aug 7, 2006

Last updated

Aug 21, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Internal MedicineAlso: Hospitalist

Education

Michigan State University College of Osteopathic Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iha Ooma Primary LLCGroup PAC ID 7012316664, 45 clinicians

Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8209/brand/5/csg/21/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/GCBDCD
• Direct secure messaging: jduong32390@direct.trinity-health.org

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.

• Iha Health Services Corporation

  dba IHA Canton Obstetrics and Gynecology

  • Obstetrics & Gynecology Physician
  • Canton, MI
  • NPI 1457408965
  Medicare reassignment Care Compare group NPD
• Iha Ooma Primary LLC

  dba IHA Bloomfield Primary Care

  • Family Medicine Physician
  • Bloomfield Township, MI
  • NPI 1245815984

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Henry Ford Health Genesys Hospital

  dba Downtown Health Center-Podiatry

  • Podiatrist
  • Flint, MI
  • NPI 1528283033
  Medicare reassignment NPD
• The Wellness Plan Medical Centers

  dba The Wellness Plan

  • Clinic/Center
  • Detroit, MI
  • NPI 1043373244
  Medicare reassignment NPD
• Ascension Genesys Hospital

  dba Ascension Genesys Short Term Rehabilitation Center

  • Skilled Nursing Facility
  • Grand Blanc, MI
  • NPI 1093125312
  NPD
• Henry Ford Health Genesys Hospital

  dba Downtown Health Center -OBGYN

  • Obstetrics & Gynecology Physician
  • Flint, MI
  • NPI 1487873691
  NPD
• Iha Health Service Corporation

  dba Trinity Health IHA Medical Group OB/GYN Float

  • Obstetrics & Gynecology Physician
  • Ypsilanti, MI
  • NPI 1831053701
  NPD
• Iha Health Services Corporation

  dba IHA Hospitalist

  • Hospitalist Physician
  • Ypsilanti, MI
  • NPI 1306121405
  NPD
• Iha Ooma Primary LLC

  • Family Medicine Physician
  • Commerce TWP, MI
  • NPI 1780470179

  Internal Medicine

  NPD
• Iha Ooma Primary LLC

  dba Trinity Health Henderson Academic Primary Care

  • Internal Medicine Physician
  • Pontiac, MI
  • NPI 1841907821
  NPD
• The Wellness Plan Medical Centers

  dba The Wellness Plan-Keys Grace Clinic

  • Federally Qualified Health Center (FQHC)
  • Madison Heights, MI
  • NPI 1114420353
  NPD
• Iha Health Services Corporation

  dba IHA Milan Primary Care

  • Family Medicine Physician
  • Milan, MI
  • NPI 1467509067
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Mercy Hospital-SMHC

  dba St Joseph Mercy Oakland

  • General Acute Care Hospital
  • Pontiac, MI
  • NPI 1053356352
  Care Compare affiliation

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377043200000",
    "number": "1780693671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 S SAGINAW ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485021803",
            "telephone_number": "810-232-3522",
            "fax_number": "810-762-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S SAGINAW ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485021803",
            "telephone_number": "810-232-3522",
            "fax_number": "810-762-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUONG",
        "first_name": "JACKY",
        "middle_name": "THUVAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2013-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101014969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "ON69170",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114632060",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114632687",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114632696",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS  GROUP",
            "identifier": "700B512440",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP NUMBER",
            "identifier": "700H248710",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114632041",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114632050",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristine Dunn, PH.D
• Tamara L Dunn, O.D.
• Katie Dunning I, LMSW
• Olivia Diane Dunning
• Samantha Dunning, LLMSW
• Latasha Dupens
• Benjamin I Dupree
• Jatanique Dupree
• William Christopher Durchholz, MD
• Carietta Kenyetta Durham

• Internal Medicine Physician in Flint, MI
• Providers in Flint, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.