Individual provider Active NPI

Nguyen Dao Ta, FNP

  • Family Nurse Practitioner
  • Saint Marys, GA
National Provider Identifier
1902608607
Registry record updated Nov 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN329048 Issued in GA
Practice address
214 Professional Cir Ste a
Saint Marys, GA 31558-3783
Phone
(912) 510-8224
NPI assigned
Mar 25, 2025
Last updated
Nov 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN329048 GA Primary

Addresses

Primary practice location

214 Professional Cir Ste a
Saint Marys, GA 31558-3783

Mailing address

126 Deep Bay Cir
Saint Marys, GA 31558-2720
Phone (714) 272-7972

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN329048GAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1742860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764374400000",
    "number": "1902608607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 DEEP BAY CIR",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315582720",
            "telephone_number": "714-272-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 PROFESSIONAL CIR STE A",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315583783",
            "telephone_number": "912-510-8224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TA",
        "first_name": "NGUYEN",
        "middle_name": "DAO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-25",
        "last_updated": "2025-11-29",
        "certification_date": "2025-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN329048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.