Individual provider Active NPI

CHI Kim Nguyen, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Pensacola, FL
National Provider Identifier
1194792309
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
ME83973 Issued in FL
Practice address
5149 N Ninth Avenue
Pensacola, FL 32504-8779
Phone
(850) 416-6894
Fax
(850) 416-2487
NPI assigned
Mar 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X ME83973 FL Primary

Addresses

Primary practice location

5149 N Ninth Avenue
Pensacola, FL 32504-8779

Mailing address

5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325

Other identifiers 2

IdentifierTypeStateIssuer
009933585MedicaidAL
266958700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040406001789 FL Practitioner - Pathology 0749273589 Reassigns benefits to 1 organization
I20160210000481 AL Practitioner - Pathology 0749273589

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vivid Pathology PAGroup PAC ID 9133106784, 12 clinicians

Practice addresses (Care Compare)

5151 N 9TH Ave
Pensacola, FL 32504-8721
Phone (850) 416-6484

Hospital & facility affiliations

  • Baptist Hospital Hospital, Pensacola, FL, CCN 100093

Merit-based Incentive Payment System (MIPS)

Final score
88.33 of 100Reported as group
Quality
76.67
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DW McMillan Memorial Hospital Current Accepting new patients
Vivid Pathology PA Anatomic Pathology & Clinical Pathology CurrentSince Jan 1, 2009 Accepting new patients
DW McMillan Memorial Hospital Current Accepting new patients
Vivid Pathology PA Anatomic Pathology & Clinical Pathology Current Accepting new patients
West Florida Medical Center Clinic PA Past Accepting new patients
Vivid Pathology PA Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

849 S Three Notch St
Andalusia, AL 36420
Phone (334) 222-6953

1301 Belleville Ave
Brewton, AL 36426
Phone (251) 809-8439

2600 Hospital Dr
Bonifay, FL 32425
Phone (850) 416-6484

1000 W Moreno St
Pensacola, FL 32501
Phone (850) 434-4011

9400 University Pkwy
Pensacola, FL 32514
Phone (850) 208-6000

5149 N 9th Ave
Ste 122
Pensacola, FL 32504
Phone (843) 518-2854

8333 N Davis Hwy
Pensacola, FL 32514
Phone (850) 474-8000

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

5700 Southwyck Blvd
Toledo, OH 43614

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1194792309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5149 N NINTH AVENUE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048779",
            "telephone_number": "850-416-6894",
            "fax_number": "850-416-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CHI",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-07",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME83973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009933585",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266958700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.