Active NPI
Bichle Thi Nguyen, D.O.
- General Practice Physician
- Mountain Home Afb, ID
National Provider Identifier
1104350024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 0102205386
- Practice address
- 90 Hope Dr BLDG 6000
Mountain Home Afb, ID 83648-1062 - Phone
- (208) 828-7401
- NPI assigned
- Apr 18, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 0102205386 | VA | Primary |
Addresses
Primary practice location
90 Hope Dr BLDG 6000
Mountain Home Afb, ID 83648-1062
Mailing address
90 Hope Dr BLDG 6000
Mountain Home Afb, ID 83648-1062
Phone (208) 828-7401
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0102205386 | Other | VA | VIRGINIA BOARD OF MEDICINE |
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102205386 | VA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763942400000",
"number": "1104350024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 HOPE DR BLDG 6000",
"city": "MOUNTAIN HOME AFB",
"state": "ID",
"postal_code": "836481062",
"telephone_number": "208-828-7401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 HOPE DR BLDG 6000",
"city": "MOUNTAIN HOME AFB",
"state": "ID",
"postal_code": "836481062",
"telephone_number": "208-828-7401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "BICHLE",
"middle_name": "THI",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-18",
"last_updated": "2025-11-24",
"certification_date": "2025-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "VA",
"license": "0102205386",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIRGINIA BOARD OF MEDICINE",
"identifier": "0102205386",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mountain Home Afb, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.