Individual provider Active NPI

Jennie Nguyen, PHARMD

  • Pharmacist
  • Oklahoma City, OK
National Provider Identifier
1053925735
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
18915 Issued in OK
Practice address
519 NW 23Rd St Ste 109
Oklahoma City, OK 73103-1509
Phone
(405) 415-3852
NPI assigned
Sep 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 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 18915 OK Primary

Addresses

Primary practice location

519 NW 23Rd St Ste 109
Oklahoma City, OK 73103-1509

Mailing address

519 NW 23Rd St Ste 109
Oklahoma City, OK 73103-1509
Phone (405) 415-3852

Other practice location 1

4913 W Reno Ave
Oklahoma City, OK 73127-6339
Phone (405) 948-4900 ext. 494

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

LicenseStateTypeSpecialty
18915OKMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince May 8, 2022 Accepting new patients
Walgreen Co PastSince Sep 6, 2020 Accepting new patients

Locations

519 NW 23rd St
Ste 109
Oklahoma City, OK 73103
Phone (405) 415-3852

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": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1053925735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 NW 23RD ST STE 109",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731031509",
            "telephone_number": "405-415-3852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 NW 23RD ST STE 109",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731031509",
            "telephone_number": "405-415-3852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4913 W Reno Ave",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731276339",
            "country_code": "US",
            "telephone_number": "405-948-4900 x494",
            "fax_number": "405-948-4929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JENNIE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "18915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.