Individual provider Active NPI

Bao Tram Thi Nguyen, D.O.

  • Obstetrics & Gynecology Physician
  • Norcross, GA
National Provider Identifier
1922416080
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
89158 Issued in GA
Practice address
4130 Steve Reynolds Blvd
Norcross, GA 30093-3059
Phone
(770) 589-1819
Fax
(678) 298-7492
NPI assigned
Jul 31, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 02004760A IN
Obstetrics & Gynecology Physician 207V00000X 89158 GA Primary

Addresses

Primary practice location

4130 Steve Reynolds Blvd
Norcross, GA 30093-3059

Mailing address

1701 Stoney Chase Dr
Lawrenceville, GA 30044-2896
Phone (678) 617-4033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211004001564 GA Practitioner - Obstetrics/Gynecology 0143579664 Reassigns benefits to 1 organization
I20241112001877 IN Practitioner - Obstetrics/Gynecology 0143579664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians
Obhg Georgia, P.C.Group PAC ID 9032383583, 34 clinicians

Practice addresses (Care Compare)

3500 Franciscan Way
Suite 300
Michigan City, IN 46360-0033
Phone (219) 877-1880

417 W 3Rd Ave
Albany, GA 31701-1943
Phone (229) 312-1000

Hospital & facility affiliations

  • Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
89158GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince Nov 16, 2024 Accepting new patients
Obhg Georgia, P.C. Obstetrics & Gynecology CurrentSince Jun 27, 2024 Accepting new patients
Franciscan Physician Network CurrentSince Nov 16, 2024 Accepting new patients
Caring Women'S OBGYN LLC Obstetrics & Gynecology Past Accepting new patients
Eastside Medical Center, LLC Past Accepting new patients

Locations

417 W 3rd Ave
Albany, GA 31701
Phone (229) 317-2207

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

1035 Red Bud Rd NE
Calhoun, GA 30701
Phone (706) 602-7800

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

1700 Medical Way
Snellville, GA 30078
Phone (770) 978-4229

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

3500 Franciscan Way
Ste 300
Michigan City, IN 46360
Phone (219) 214-4633

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

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 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": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1922416080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 STONEY CHASE DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300442896",
            "telephone_number": "678-617-4033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 STEVE REYNOLDS BLVD",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300933059",
            "telephone_number": "770-589-1819",
            "fax_number": "678-298-7492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "BAO TRAM",
        "middle_name": "THI",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "02004760A",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "89158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

Verify at the official NPI Registry.