Individual provider Active NPI

Faustine Luu Dinh, D.O.

  • Internal Medicine Physician
  • Braselton, GA
National Provider Identifier
1922411537
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
077724 Issued in GA
Practice address
1515 River PL Ste 200
Braselton, GA 30517-5603
Phone
(770) 848-6140
Fax
(770) 848-6141
NPI assigned
Jun 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LL36700 SC
Internal Medicine Physician 207R00000X 077724 GA Primary

Addresses

Primary practice location

1515 River PL Ste 200
Braselton, GA 30517-5603

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

701 Grove Rd
5th Floor Support Tower
Greenville, SC 29605-4210
Phone (864) 455-7882

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address fdinh29533@nghs.gadirect.net Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171103000774 GA Practitioner - Internal Medicine 4789803099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Johns Creek Primary Care Physicians LLCGroup PAC ID 3577552116, 4 clinicians

Practice addresses (Care Compare)

4365 Johns Creek Pkwy
Suwanee, GA 30024-1059
Phone (678) 957-1910

Hospital & facility affiliations

  • Northside Hospital Hospital, Atlanta, GA, CCN 110161

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL36700SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Van Maele Medical PC Internal Medicine Past Accepting new patients

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.

Hospital & facility affiliations 1

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": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1922411537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 RIVER PL STE 200",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305175603",
            "telephone_number": "770-848-6140",
            "fax_number": "770-848-6141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Grove Rd",
            "address_2": "5th Floor Support Tower",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054210",
            "country_code": "US",
            "telephone_number": "864-455-7882",
            "fax_number": "864-455-5008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DINH",
        "first_name": "FAUSTINE",
        "middle_name": "LUU",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-11",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "LL36700",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "077724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fdinh29533@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1515 River Pl Ste 200",
            "city": "Braselton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305175603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Braselton, GA

Sources for this page

Verify at the official NPI Registry.