Chamblee Family Medical Clinic LLC
Organization Active NPI Family Nurse Practitioner · Chamblee, GA
NPI 1821709262 · NPPES record last updated Jun 4, 2026
Key facts
- NPI
- 1821709262
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- Legal business name
- CHAMBLEE FAMILY MEDICAL CLINIC LLC
- Practice address
- 4897 Buford Hwy Ste 167
Chamblee, GA 30341-3670 - Phone
- (770) 872-8141
- Fax
- (770) 872-8142
- NPI assigned
- Dec 7, 2022
- Organization subpart
- No
Authorized official
- Name
- Vincent CHI Nguyen, DNP
- Title
- DNP
- Phone
- (770) 872-8141
Practitioners 1
-
Vincent CHI Nguyen, DNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2276317 | Chamblee Family Medical Clinic | Certificate of waiver | Feb 6, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230202003135 | GA | Part B Supplier - Clinic/Group Practice | 1456723329 |
Receives reassigned benefits from 1 practitioner Practice locations: Chamblee, GA |
National Provider Directory
Locations
4897 Buford Hwy
Ste 167
Chamblee, GA 30341
Phone (770) 452-5642
1630 Pleasant Hill Rd
Ste 120
Duluth, GA 30096
Phone (770) 872-8141
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | Yes |
Addresses
Primary practice location
4897 Buford Hwy Ste 167
Chamblee, GA 30341-3670
Mailing address
4897 Buford Hwy Ste 167
Chamblee, GA 30341-3670
Phone (770) 872-8141
Other practice location 1
1630 Pleasant Hill Rd Ste 120
Duluth, GA 30096-5899
Phone (770) 872-8141
Other providers in Chamblee, GA
- Celestial Private Homecare LLC
- CH'I Chiropractic Wellness Center, LLC
- Mary Turner Chace
- Chamblee Children'S Clinic , P.C.
- Chamblee Dunwoody Family Dentistry LLC
- Chamblee Medical Clinic
- Dennis Chan
- Carol Kai-Hua Chang
- Shi Chieh Chang
- Tatiana Danielle Chapple
All providers in Chamblee, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.