Active NPI
Joey Mark Nguyen, PHARMD
- Pharmacist
- Dorchester, MA
National Provider Identifier
1033720875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P-MA-CV19-718684
- Practice address
- 747 Gallivan Blvd
Dorchester, MA 02122 - Phone
- (617) 282-5246
- Fax
- (617) 288-5242
- NPI assigned
- Aug 14, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 79987 | CA | |
| Pharmacist | 183500000X | 59686 | TX | |
| Pharmacist | 183500000X | P-MA-CV19-718684 | MA | Primary |
Addresses
Primary practice location
747 Gallivan Blvd
Dorchester, MA 02122
Mailing address
747 Gallivan Blvd
Dorchester, MA 02122
Phone (617) 282-5246
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
| License | State | Type | Specialty |
|---|---|---|---|
| 79987 | CA | MD | Pharmacist |
| P-MA-CV19-718684 | MA | MD | Pharmacist |
| 59686 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597363200000",
"number": "1033720875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "747 GALLIVAN BLVD",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "02122",
"telephone_number": "617-282-5246",
"fax_number": "617-288-5242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "747 GALLIVAN BLVD",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "02122",
"telephone_number": "617-282-5246",
"fax_number": "617-288-5242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "JOEY",
"middle_name": "MARK",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-14",
"last_updated": "2020-08-14",
"certification_date": "2020-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "79987",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "59686",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "P-MA-CV19-718684",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dorchester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.