PHUONGTAM NGUYEN MD
NPI 1053765057
Psychiatry & Neurology - Child & Adolescent Psychiatry in Villa Rica, GA

Q: What is Phuongtam Nguyen's NPI number?

The NPI number for Phuongtam Nguyen is 1053765057. It was assigned to this individual provider in the NPPES registry on April 16, 2016.

Q: What is Phuongtam Nguyen's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Q: When was this NPI record last updated?

The NPPES record for Phuongtam Nguyen was last updated on May 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 16, 2016PECOS Enrolled

101 QUARTZ DR STE 103, VILLA RICA, GA 30180(770) 812-3530(770) 812-3531 Get Directions Write a Review

NPPES record last updated: May 13, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 13, 2021, May 26, 2020 (2 updates tracked since 2020).

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About Phuongtam Nguyen Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHUONGTAM NGUYEN MD (NPI 1053765057) is an individual child & adolescent psychiatry provider in Villa Rica, Georgia, licensed in Georgia (83914) and active in the NPI registry since April 2016. She is enrolled in Medicare PECOS, maintains a secondary practice location in Gainesville, and is a graduate of Howard University College Of Medicine (2016).

NPPES Registry Identity

NPI1053765057

Entity TypeIndividualFemale

Primary Taxonomy2084P0804X

Provider Legal NamePHUONGTAM NGUYENCredential: MD

Location Address101 QUARTZ DR STE 103Villa Rica, GA 30180-3255

Mailing Address4037 Nw 86th TerGainesville, FL 32606-9277

Phone(770) 812-3530

Fax(770) 812-3531

Sole ProprietorNo

Medical School CMSHoward University College Of MedicineGraduated 2016

Enumeration DateApril 16, 2016

Last NPPES UpdateMay 13, 20212 updates tracked since enumeration

NPPES CertifiedMay 13, 2021

✔ NPI 1053765057 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0804X

License✔ Licensed in GA · 83914

Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

101 QUARTZ DR STE 103, Villa Rica, GA 30180

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Secondary Practice Location 1

Location 14037 NW 86th TerGainesville, FL 32606-9277 · Phone (352) 265-4357

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Phuongtam Nguyen Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID244527851

PECOS Enrollment IDI20200708003328

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. WILLIAM SCHNEIDER M.D.

Psychiatry & Neurology (Forensic Psychiatry)