Active NPI
John-Minh Nguyen, D.O
- Psychiatry Physician
- Nampa, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- O-1139
- Practice address
- 9850 W St Lukes Dr
Nampa, ID 83687-7912 - Phone
- (208) 706-6375
- Fax
- (208) 706-6395
- NPI assigned
- Jun 21, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | O-1139 | ID | Primary |
| Psychiatry Physician | 2084P0800X | 5101021384 | MI |
Addresses
Primary practice location
9850 W St Lukes Dr
Nampa, ID 83687-7912
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Other practice location 1
965 Fee Rd
A233
East Lansing, MI 48824-6569
Phone (714) 823-5892
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
9580 W St Lukes Dr
Nampa, ID 83687-7912
Phone (208) 505-2711
9850 St Lukes Dr
Nampa, ID 83687-7912
9850 W St Luke's Dr
Nampa, ID 83687-7912
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101021384 | MI | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pocatello Health Services, LLC | Current | Accepting new patients | |
| Pocatello Health Services, LLC | Current | Accepting new patients | |
| St Lukes Clinic-Treasure Valley LLC | Current | Accepting new patients | |
| Pocatello Health Services, LLC | Current | Accepting new patients |
Locations
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
9850 W St Lukes Dr
Nampa, ID 83687
Phone (208) 205-7282
777 Hospital Way
Pocatello, ID 83201
Phone (208) 239-1000
777 Hospital Way
Ste 202
Pocatello, ID 83201
Phone (208) 239-2640
Interoperability endpoints
- jnguyen264720@ahs.direct-ci.com
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Boise, ID
- NPI 1326336058
-
- Durable Medical Equipment & Medical Supplies
- Pocatello, ID
- NPI 1154089126
-
dba Portneuf Medical Practices
- General Acute Care Hospital
- Pocatello, ID
- NPI 1215165485
-
- General Acute Care Hospital
- Pocatello, ID
- NPI 1689802852
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St Lukes Meridian Medical Center
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
-
dba St Lukes Nampa Medical Center
- General Acute Care Hospital
- Nampa, ID
- NPI 1831590660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731283200000",
"number": "1013322783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9850 W ST LUKES DR",
"city": "NAMPA",
"state": "ID",
"postal_code": "836877912",
"telephone_number": "208-706-6375",
"fax_number": "208-706-6395"
}
],
"practiceLocations": [
{
"address_1": "965 Fee Rd",
"address_2": "A233",
"address_purpose": "LOCATION",
"city": "East Lansing",
"state": "MI",
"postal_code": "488246569",
"country_code": "US",
"telephone_number": "714-823-5892",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NGUYEN",
"first_name": "JOHN-MINH",
"credential": "D.O",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-06-21",
"last_updated": "2024-11-11",
"certification_date": "2024-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "ID",
"license": "O-1139",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "5101021384",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.