Phillip Hiroto Nakano, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

024310 Issued in GA

Practice address

3096 Peachtree Industrial Blvd
Duluth, GA 30097-7918

Phone

(770) 495-1477

Fax

(770) 495-1488

NPI assigned

Sep 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Prima Center for Plastic Surgery PC

  • Specialist
  • Duluth, GA
  • NPI 1114065935
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962502252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3096 PEACHTREE INDUSTRIAL BLVD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300977918",
            "telephone_number": "770-495-1477",
            "fax_number": "770-495-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3096 PEACHTREE INDUSTRIAL BLVD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300977918",
            "telephone_number": "770-495-1477",
            "fax_number": "770-495-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKANO",
        "first_name": "PHILLIP",
        "middle_name": "HIROTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "024310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52026987",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00486351A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "686583",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber A Myles
• Kyra K Myles
• Mystique Homecare Agency
• Deepalakshmi Nagarajan, M.D
• Noshin Najafi, MD
• Nam Ki Chiropractic L.L.C
• Sangwoo Nam, DDS
• Soo Jin Nam, DDS
• Judith Namakula, N.P-C
• Ilnae Clara Namgung, PHARMD

• Plastic Surgery Physician in Duluth, GA
• Providers in Duluth, GA by specialty
• Plastic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.