Individual provider Active NPI

Ling Qin, NP

  • Acute Care Nurse Practitioner
  • Cumming, GA
National Provider Identifier
1790859536
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN143497 Issued in GA
Practice address
3850 Windermere Pkwy Ste 105
Cumming, GA 30041-7033
Phone
(678) 455-2800
Fax
(770) 888-9998
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Clinical Nurse Specialist 364SA2100X RN143497 GA
Nurse Practitioner 363L00000X RN143497 GA
Adult Health Nurse Practitioner 363LA2200X RN143497 GA
Acute Care Nurse Practitioner 363LA2100X RN143497 GA Primary

Addresses

Primary practice location

3850 Windermere Pkwy Ste 105
Cumming, GA 30041-7033

Mailing address

3850 Windermere Pkwy Ste 105
Cumming, GA 30041-7033
Phone (678) 455-2800

Other identifiers 10

IdentifierTypeStateIssuer
395864656KMedicaidGA
395864656AMedicaidGA
395864656DMedicaidGA
395864656EMedicaidGA
P00447454OtherGAMEDICARE RAILROAD
381898OtherGAWELLCARE
395864656CMedicaidGA
10075392OtherGAAMERIGROUP
395864656BMedicaidGA
395864656IMedicaidGA

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
I20061228000171 GA Practitioner - Nurse Practitioner 6901806850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

3850 Windermere Pkwy
Suite 105
Cumming, GA 30041-7002
Phone (678) 455-2800

901 Haymon Morris Rd
Winder, GA 30680-7837
Phone (678) 705-2123

Merit-based Incentive Payment System (MIPS)

Final score
89.1 of 100Reported as group
Quality
87.6
Promoting interoperability
100
Improvement activities
40
Cost
76.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN143497GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Primary Care Professional Services,LLC CurrentSince Jul 28, 2023 Accepting new patients
Northside Primary Care Professional Services, LLC CurrentSince Jul 28, 2023 Accepting new patients

Locations

3850 Windermere Pkwy
Ste 105
Cumming, GA 30041
Phone (678) 455-2800

3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

Interoperability endpoints

  • Direct secure messaging: ling.qin@longstreetclinic.gadirect.net

Organizations & group practices 2

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1790859536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 WINDERMERE PKWY STE 105",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417033",
            "telephone_number": "678-455-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 WINDERMERE PKWY STE 105",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417033",
            "telephone_number": "678-455-2800",
            "fax_number": "770-888-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QIN",
        "first_name": "LING",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "GA",
            "license": "RN143497",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN143497",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN143497",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN143497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "395864656K",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "395864656A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "395864656D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "395864656E",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00447454",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "381898",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "395864656C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10075392",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "395864656B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "395864656I",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.