Individual provider Active NPI

Bichle Thi Nguyen, D.O.

  • General Practice Physician
  • Mountain Home Afb, ID
National Provider Identifier
1104350024
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
0102205386 Issued in VA
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

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0102205386OtherVAVIRGINIA 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

LicenseStateTypeSpecialty
0102205386VAMDGeneral 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.

Verify at the official NPI Registry.