CHAMBLEE FAMILY MEDICAL CLINIC LLC
NPI 1821709262
Nurse Practitioner - Family in Chamblee, GA
About Chamblee Family Medical Clinic Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CHAMBLEE FAMILY MEDICAL CLINIC LLC (NPI 1821709262) is a healthcare organization registered as a family in Chamblee, Georgia and active in the NPI registry since December 2022. The organization holds a CLIA Waiver certificate valid through February 6, 2027, maintains a secondary practice location in Duluth, and lists Vincent Chi Nguyen, Dnp, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Chamblee Family Medical Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Chamblee Family Medical Clinic LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 11D2276317
Chamblee Family Medical Clinic · Chamblee, GAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Chamblee Family Medical Clinic LLC's NPI number?
The NPI number for Chamblee Family Medical Clinic LLC is 1821709262. It was assigned to this organization in the NPPES registry on December 7, 2022.
Where is Chamblee Family Medical Clinic LLC located?
Chamblee Family Medical Clinic LLC is located at 4897 Buford Hwy Ste 167, Chamblee, GA 30341. The listed phone number is (770) 872-8141.
What is Chamblee Family Medical Clinic LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Chamblee Family Medical Clinic LLC enrolled in Medicare?
Yes. Chamblee Family Medical Clinic LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Chamblee Family Medical Clinic LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Chamblee Family Medical Clinic LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Chamblee Family Medical Clinic LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 11D2276317) is associated with this NPI, valid through February 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Chamblee Family Medical Clinic LLC was last updated on June 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.
# Chamblee Family Medical Clinic Llc · NPI 1821709262
Family organization in Chamblee, Georgia. Organization record, active in the CMS NPPES registry since December 7, 2022.
## Identity
- **NPI:** 1821709262 (Entity type: Organization)
- **Enumerated:** December 7, 2022
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Vincent Nguyen, DNP
## Practice location
- **Address:** 4897 BUFORD HWY STE 167, Chamblee, GA 30341-3670
- **Phone:** (770) 872-8141 · **Fax:** (770) 872-8142
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 4, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1821709262) · Data from the CMS NPPES public registry.