Individual provider Active NPI

Hoa Tuyet Nguyenpho, M.D.

  • Specialist
  • Jacksonville, FL
National Provider Identifier
1124124177
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME 51857 Issued in FL
Practice address
1833 Boulevard
Jacksonville, FL 32206-4382
Phone
(904) 232-2751
Fax
(904) 232-2149
NPI assigned
Sep 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME 51857 FL Primary

Addresses

Primary practice location

1833 Boulevard
Jacksonville, FL 32206-4382

Mailing address

10270 Cypress Lakes Dr
Jacksonville, FL 32256-3640
Phone (904) 519-8979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 51857FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Electrocardiography, Inc Specialist Past Accepting new patients
Southern Heart Group Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: hoa.nguyen-pho.1@16002.direct.athenahealth.com

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124124177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10270 CYPRESS LAKES DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563640",
            "telephone_number": "904-519-8979",
            "fax_number": "904-519-9166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 BOULEVARD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322064382",
            "telephone_number": "904-232-2751",
            "fax_number": "904-232-2149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYENPHO",
        "first_name": "HOA",
        "middle_name": "TUYET",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME 51857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.