Individual provider Active NPI

Bao Tram Nguyen, APRN

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1043575749
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3007548 Issued in KY
Practice address
4402 Churchman Ave Ste 410
Louisville, KY 40215-3102
Phone
(502) 367-6322
NPI assigned
Jul 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3007548 KY Primary

Addresses

Primary practice location

4402 Churchman Ave Ste 410
Louisville, KY 40215-3102

Mailing address

4402 Churchman Ave Ste 410
Louisville, KY 40215-3102
Phone (502) 367-6322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140703001823 KY Practitioner - Nurse Practitioner 1850516972 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

2400 Eastpoint Pkwy
Suite 100
Louisville, KY 40223-4154
Phone (502) 210-4800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3007548KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Oct 19, 2022 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Oct 19, 2022 Accepting new patients
Southend Gastroenterology Associates PLLC CurrentSince Feb 1, 2022 Accepting new patients
Pearl Medical Practice PLLC PastSince Jan 31, 2021 Accepting new patients

Locations

4402 Churchman Ave
Ste 211
Louisville, KY 40215
Phone (502) 361-6070

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

2400 Eastpoint Pkwy
Ste 100
Louisville, KY 40223
Phone (502) 210-4700

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1043575749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4402 CHURCHMAN AVE STE 410",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402153102",
            "telephone_number": "502-367-6322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4402 CHURCHMAN AVE STE 410",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402153102",
            "telephone_number": "502-367-6322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "BAO TRAM",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-09",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3007548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.