DR. JENNY THUY PHAN (NPI# 1245336221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245336221 |
| Entity Type | Individual |
| Full Name | DR. JENNY THUY PHAN |
| Credential | D.C. |
| Practice Address |
3675 Crestwood Pkwy Nw Suite 400 Duluth GA 30096-1805 |
| Mailing Address |
1434 Sydney Pond Cir Lawrenceville GA 30045-3361 |
| Practice Telephone | 7708952646 |
| Practice Fax Number | 7709356175 |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CHIR007466 | GA | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ACN GROUP | 669421 | 01 | |
| CIGNA | 6365410 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730668757 | Jenny Phan | Student in an Organized Health Care Education/Training Program | 1556 S Sultana Ave, Ontario, CA 91761-4238 | 2018-08-09 |
| 1124568225 | Jenny Phan | Physician Assistant | 21770 Kingsland Blvd, Katy, TX 77450-2513 | 2017-03-08 |
| 1982015210 | Jenny Phan | Family Medicine | 26520 Cactus Ave, Family Medicine Department, Moreno Valley, CA 92555-3927 | 2014-05-08 |
| Street Address |
3675 CRESTWOOD PKWY NW SUITE 400 |
| City | DULUTH |
| State | GA |
| Zip Code | 30096-1805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053968230 | Kenya Norris | Behavior Technician | 3675 Crestwood Pkwy Nw, Duluth, GA 30096-1805 | 2019-08-21 |
| 1477922748 | Pure Care Center | Massage Therapist | 3675 Crestwood Pkwy Nw, Suite 290, Duluth, GA 30096-1805 | 2015-09-17 |
| 1679918270 | A New Direction Counseling and Support Services LLC | Counselor | 3675 Crestwood Pkwy Nw, 4th Floor, Suite# 401, Duluth, GA 30096-1805 | 2013-05-08 |
| 1467709162 | South Star Transport, Inc | Non-emergency Medical Transport (VAN) | 3675 Crestwood Pkwy Nw, Duluth, GA 30096-1805 | 2012-08-13 |
| 1154567329 | Worthy Medical Supply Inc. | Durable Medical Equipment & Medical Supplies | 3675 Crestwood Pkwy Nw, Suite 290, Duluth, GA 30096-1805 | 2008-12-18 |
| 1720284862 | Nathan Mascaro | Psychologist | 3675 Crestwood Pkwy Nw, Duluth, GA 30096-1805 | 2007-06-25 |
| 1811013485 | Connie Burchette Smith | Psychologist | 3675 Crestwood Pkwy Nw, Suite 550, Duluth, GA 30096-1805 | 2007-03-22 |
| 1427117969 | Julie A Friedman | Psychologist | 3675 Crestwood Pkwy Nw, Suite 550, Duluth, GA 30096-1805 | 2006-12-08 |
| 1235208323 | Steven E Weinstein | Psychologist | 3675 Crestwood Pkwy Nw, Suite 550, Duluth, GA 30096-1805 | 2006-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922615897 | Georgia Eye Optical, LLC | Ophthalmology | 3800 Pleasant Hill Rd Ste 3, Duluth, GA 30096 | 2020-09-25 |
| 1568090868 | Positive Behavior Services, Inc | Behavior Technician | 3765 Crestwood Pkwy Nw, Duluth, GA 30096 | 2020-03-31 |
| 1861031940 | Elizabeth Ashley Edouard | Counselor | 3464 Duluth Hwy 120, Duluth, GA 30096 | 2020-01-06 |
| 1245701044 | Kathryn Irene Vaughn | Social Worker | 3968 Mainsail Court, Duluth, GA 30096 | 2018-12-06 |
| 1083184626 | Aica Orthopedics, P.C. | Orthopaedic Surgery | 3775 Venture Drive Bldg F, Duluth, GA 30096 | 2018-11-27 |
| 1245709799 | Positive Impact Health Centers, Inc. | Pharmacy | 3350 Breckinridge Blvd, Suite 200a, Duluth, GA 30096 | 2018-11-14 |
| 1235611724 | Katherine Winstead Knott | Counselor | 3460 Summit Ridge Parkway, Suite 503, Duluth, GA 30096 | 2018-08-31 |
| 1710467857 | Envision Optics LLC | Optometrist | 1943 Pleasant Hill Rd, Duluth, GA 30096 | 2018-08-17 |
| 1104314202 | Erin Mckernan Scupham | Chiropractor | 3820 Pleasant Hill Rd. Ne, Suite 4, Duluth, GA 30096 | 2018-04-25 |
| 1053839456 | Rogers Bridge Pediatric Therapy, LLC | Clinic/Center | 2845 Summercrest Ln, Duluth, GA 30096 | 2017-09-06 |
| Find all providers in zip 30096 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164034591 | Chantelle Frazier | Chiropractor | 2131 Pleasant Hill Rd Ste 122, Duluth, GA 30096-4657 | 2020-08-18 |
| 1396371571 | Northern Lakes Chiropractic LLC | Chiropractor | 2340 Mountain Shadow Dr, Duluth, MN 55811-3809 | 2020-03-19 |
| 1578113973 | Chester Creek Chiropractic | Chiropractor | 1324 E 4th St Ste A, Duluth, MN 55805-2335 | 2019-09-17 |
| 1467007997 | Pleasant Hill Chiropractic | Chiropractor | 4390 Pleasant Hill Rd Ste G, Duluth, GA 30096-8054 | 2019-08-01 |
| 1851951024 | Marian Denisse Ortiz Rodriguez | Chiropractor | 3775 Venture Dr Bldg F, Duluth, GA 30096-5102 | 2019-06-19 |
| 1396234613 | Sangsoo Lee | Chiropractor | 2148 Duluth Highway 120 Ste 110, Duluth, GA 30097-4504 | 2018-05-02 |
| 1104314202 | Erin Mckernan Scupham | Chiropractor | 3820 Pleasant Hill Rd. Ne, Suite 4, Duluth, GA 30096 | 2018-04-25 |
| 1942708235 | Kyle Severson | Chiropractor | 224 E Central Entrance Ste C, Duluth, MN 55811-5518 | 2018-02-01 |
| 1669987228 | Frances Hearn | Chiropractor | 2719 Irene Cir, Duluth, GA 30096-4149 | 2017-12-05 |
| 1467966911 | Corey Steven Milbrandt | Chiropractor | 925 E Superior St Ste 112, Duluth, MN 55802-2253 | 2017-11-20 |
| Find all providers in DULUTH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.