Individual provider Active NPI

Thu Anh Nguyen

  • Family Nurse Practitioner
  • Gonzales, LA
National Provider Identifier
1104509314
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP234181 Issued in LA
Practice address
42568 Cedar Park Ave
Gonzales, LA 70737-7165
Phone
(504) 520-0373
NPI assigned
Aug 14, 2023
Last updated
Apr 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP234181 LA Primary

Addresses

Primary practice location

42568 Cedar Park Ave
Gonzales, LA 70737-7165

Mailing address

42568 Cedar Park Ave
Gonzales, LA 70737-7165
Phone (504) 520-0373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240704000298 LA Practitioner - Nurse Practitioner 1658815378 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP234181LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Network, LLC Nurse Practitioner CurrentSince Oct 1, 2024 Accepting new patients
Mayfair Physician Services, LLC Nurse Practitioner CurrentSince May 17, 2024 Accepting new patients

Locations

11414 Lake Sherwood Ave N
Baton Rouge, LA 70816
Phone (225) 532-4058

17000 Medical Center Dr
Baton Rouge, LA 70816
Phone (225) 752-2470

5130 Mancuso Ln
Baton Rouge, LA 70809
Phone (225) 490-9600

25455 Highway 1
Plaquemine, LA 70764
Phone (225) 754-6870

Interoperability endpoints

  • Direct secure messaging: tnguyen2263315@direct.ochsner.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1104509314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42568 CEDAR PARK AVE",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707377165",
            "telephone_number": "504-520-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42568 CEDAR PARK AVE",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707377165",
            "telephone_number": "504-520-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THU",
        "middle_name": "ANH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP234181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gonzales, LA

Sources for this page

Verify at the official NPI Registry.