Individual provider Active NPI

Anh Ngoc Nguyen, NURSE PRACTITIONER

  • Nurse Practitioner
  • Cartersville, GA
National Provider Identifier
1902451404
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN219622 Issued in GA
Practice address
78 Opal St
Cartersville, GA 30120-2848
Phone
(770) 382-6120
NPI assigned
Aug 2, 2019
Last updated
Oct 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN219622 GA Primary

Addresses

Primary practice location

78 Opal St
Cartersville, GA 30120-2848

Mailing address

13 Starlight Dr NW Ste C
Cartersville, GA 30121-9263
Phone (706) 331-6972

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
I20210212001706 GA Practitioner - Nurse Practitioner 5799190344 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regenerative Wound Solutions PCGroup PAC ID 2668917865, 3 clinicians

Practice addresses (Care Compare)

2850 Springdale Rd SW
Atlanta, GA 30315-7802
Phone (212) 734-6621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Renew Wound Care of Georgia LLC CurrentSince Aug 1, 2021 Accepting new patients
HCR Manorcare Medical Services of Florida LLC Nurse Practitioner CurrentSince Mar 1, 2021 Accepting new patients
Regenerative Wound Solutions PC CurrentSince May 1, 2024 Accepting new patients
Medical Director Services PC CurrentSince Mar 11, 2024 Accepting new patients

Locations

2850 Springdale Rd SW
Atlanta, GA 30315
Phone (404) 616-8100

5131 Warm Springs Rd
Columbus, GA 31909
Phone (706) 561-1371

2722 N Decatur Rd
Decatur, GA 30033
Phone (404) 292-0626

1481 McDonald Ave
Brooklyn, NY 11230
Phone (347) 479-1110

L2540
Columbus, OH 43260

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1564704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1902451404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 STARLIGHT DR NW STE C",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301219263",
            "telephone_number": "706-331-6972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 OPAL ST",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202848",
            "telephone_number": "770-382-6120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANH",
        "middle_name": "NGOC",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-02",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN219622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

Verify at the official NPI Registry.