NPIMap

Individual provider Active NPI

Christine Liqun Bao, M.D.

  • Family Medicine Physician
  • Norcross, GA
National Provider Identifier
1831175132
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
043539 Issued in GA
Practice address
777 W Peachtree St
Norcross, GA 30071-1868
Phone
(770) 246-6100
Fax
(770) 246-6142
NPI assigned
Dec 19, 2005
Last updated
Jun 23, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 043539 GA Primary

Addresses

Primary practice location

777 W Peachtree St
Norcross, GA 30071-1868

Mailing address

777 W Peachtree St
Norcross, GA 30071-1868
Phone (770) 246-6100

Other identifiers 1

IdentifierTypeStateIssuer
00753728HMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080516000004 GA Practitioner - Family Practice 9830268895 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Buford-Norcross Primary Care, P.C.Group PAC ID 9032104583, 5 clinicians
Excelsior Healthcare LLCGroup PAC ID 0840786000, 5 clinicians
Excelsior Healthcare Partners LLCGroup PAC ID 2062943483, 3 clinicians

Practice addresses (Care Compare)

4855 River Green Pkwy
Suite 520
Duluth, GA 30096-8337
Phone (678) 417-1588

777 W Peachtree St
Norcross, GA 30071-1868
Phone (770) 246-6100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
043539GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cai Hong Senior Services Inc CurrentSince Nov 18, 2020 Accepting new patients
Buford-Norcross Primary Care, P.C. Family Medicine CurrentSince Jun 1, 1999 Accepting new patients
Excelsior Healthcare Partners LLC Family Medicine CurrentSince Sep 21, 2024 Accepting new patients
Excelsior Healthcare LLC Family Medicine CurrentSince Nov 11, 2025 Accepting new patients
Family Care Centers Trust Past Accepting new patients

Locations

4855 River Green Pkwy
Ste 520
Duluth, GA 30096
Phone (678) 417-1588

3079 Crossing Park
Norcross, GA 30071
Phone (404) 890-0034

777 W Peachtree St
Norcross, GA 30071
Phone (770) 246-6100

3895 Johns Creek Pkwy
Ste B
Suwanee, GA 30024
Phone (770) 203-0618

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308787200000",
    "number": "1831175132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 W PEACHTREE ST",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300711868",
            "telephone_number": "770-246-6100",
            "fax_number": "770-246-6142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 W PEACHTREE ST",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300711868",
            "telephone_number": "770-246-6100",
            "fax_number": "770-246-6142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAO",
        "first_name": "CHRISTINE",
        "middle_name": "LIQUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2011-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "043539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00753728H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

Verify at the official NPI Registry.