Individual provider Active NPI

Yen Kim Ngo, PHARM.D.

  • Pharmacist
  • Mount Juliet, TN
National Provider Identifier
1003153164
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
36042 Issued in TN
Practice address
11207 Lebanon Rd
Mount Juliet, TN 37122-5545
Phone
(615) 758-9830
Fax
(615) 758-9820
NPI assigned
Jan 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 36042 TN Primary

Addresses

Primary practice location

11207 Lebanon Rd
Mount Juliet, TN 37122-5545

Mailing address

11207 Lebanon Rd
Mount Juliet, TN 37122-5545
Phone (615) 758-9830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
36042TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Publix Tennessee LLC PastSince Mar 3, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1003153164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11207 LEBANON RD",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371225545",
            "telephone_number": "615-758-9830",
            "fax_number": "615-758-9820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11207 LEBANON RD",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371225545",
            "telephone_number": "615-758-9830",
            "fax_number": "615-758-9820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO",
        "first_name": "YEN",
        "middle_name": "KIM",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-09",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "36042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Juliet, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.