Individual provider Active NPI

Kim Quy Vo Nguyen, FNP-C

  • Family Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1053861161
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60680756 Issued in WA
Practice address
11011 Meridian Ave N Ste 200
Seattle, WA 98133-8967
Phone
(206) 329-1760
NPI assigned
Oct 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201507391NP-PP OR
Family Nurse Practitioner 363LF0000X AP60680756 WA Primary

Addresses

Primary practice location

11011 Meridian Ave N Ste 200
Seattle, WA 98133-8967

Mailing address

11011 Meridian Ave N Ste 200
Seattle, WA 98133-8967
Phone (206) 329-1760

Other practice location 1

19200 N Kelsey St
Monroe, WA 98272-1431
Phone (360) 794-7994

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address knguyen1016292@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
55.39 of 100Reported as group
Quality
22.71
Promoting interoperability
100
Improvement activities
0
Cost
78.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201507391NP-PPORMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1053861161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11011 MERIDIAN AVE N STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338967",
            "telephone_number": "206-329-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11011 MERIDIAN AVE N STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338967",
            "telephone_number": "206-329-1760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19200 N Kelsey St",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "WA",
            "postal_code": "982721431",
            "country_code": "US",
            "telephone_number": "360-794-7994",
            "fax_number": "360-805-4755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KIM QUY",
        "middle_name": "VO",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-12",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201507391NP-PP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60680756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knguyen1016292@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "19200 N Kelsey St",
            "city": "Monroe",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982721431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.