Individual provider Active NPI

Loan Thi Kieu Nguyen

  • Pharmacist
  • Kissimmee, FL
National Provider Identifier
1043823776
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS60372 Issued in FL
Practice address
395 Cypress Pkwy
Kissimmee, FL 34759-3326
Phone
(407) 343-8224
Fax
(407) 343-8339
NPI assigned
Aug 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS60372 FL Primary

Addresses

Primary practice location

395 Cypress Pkwy
Kissimmee, FL 34759-3326

Mailing address

5615 Stull Ave
Orlando, FL 32810-4530
Phone (407) 350-9980

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

State licenses

LicenseStateTypeSpecialty
PS60372FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co. CurrentSince Feb 27, 2022 Accepting new patients
Walgreen Co PastSince Aug 30, 2020 Accepting new patients

Locations

395 Cypress Pkwy
Kissimmee, FL 34759
Phone (407) 343-8224

Organizations & group practices 2

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": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1043823776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5615 STULL AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328104530",
            "telephone_number": "407-350-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 CYPRESS PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347593326",
            "telephone_number": "407-343-8224",
            "fax_number": "407-343-8339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "LOAN",
        "middle_name": "THI KIEU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-24",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS60372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.

Verify at the official NPI Registry.