Active NPI
Trang Nguyen, OD
- Optometrist
- Taylor, MI
National Provider Identifier
1013364595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901004984
- Practice address
- 22320 Goddard Rd
Taylor, MI 48180-4234 - Phone
- (313) 299-8872
- NPI assigned
- May 16, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901004984 | MI | Primary |
Addresses
Primary practice location
22320 Goddard Rd
Taylor, MI 48180-4234
Mailing address
118 Cass Ave
Mount Clemens, MI 48043-2204
Phone (586) 468-7370
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4901004984 | MI | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467244800000",
"number": "1013364595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 CASS AVE",
"city": "MOUNT CLEMENS",
"state": "MI",
"postal_code": "480432204",
"telephone_number": "586-468-7370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22320 GODDARD RD",
"city": "TAYLOR",
"state": "MI",
"postal_code": "481804234",
"telephone_number": "313-299-8872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "TRANG",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-16",
"last_updated": "2016-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901004984",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taylor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.