Individual provider Active NPI

Kimberly Nguyen, FNP-C

  • Family Nurse Practitioner
  • Neosho, MO
National Provider Identifier
1215287750
Registry record updated Nov 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2012031598 Issued in MO
Practice address
117 E Hickory St
Neosho, MO 64850-1806
Phone
(417) 451-4545
NPI assigned
Sep 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2013

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 2012031598 MO Primary

Addresses

Primary practice location

117 E Hickory St
Neosho, MO 64850-1806

Mailing address

117 E Hickory St
Neosho, MO 64850-1806
Phone (417) 451-4545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20121029000540 MO Practitioner - Nurse Practitioner 7214187202 Reassigns benefits to 1 organization
I20240927001113 KS Practitioner - Nurse Practitioner 7214187202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Joplin LLCGroup PAC ID 0547300196, shared by 3 NPIs, 288 clinicians

Practice addresses (Care Compare)

1717 S Range Line Rd B
Mercy Convenient Care
Joplin, MO 64804-3224
Phone (417) 623-2207

444 Four States Dr
Suite 1
Galena, KS 66739-4325
Phone (877) 783-4441

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Joplin LLC CurrentSince Sep 30, 2024 Accepting new patients
Mercy Clinic Joplin LLC CurrentSince Sep 30, 2024 Accepting new patients
WH Ar Medical PLLC Past Accepting new patients

Locations

220 N Pennsylvania Ave
Columbus, KS 66725
Phone (620) 429-2545

403 Woodland Hills Blvd
Fort Scott, KS 66701
Phone (417) 556-4762

444 Four States Dr
Ste 1
Galena, KS 66739
Phone (877) 783-4441

3125 Dr Russell Smith Way
Carthage, MO 64836
Phone (417) 358-8121

94 Main St
Cassville, MO 65625
Phone (417) 782-7722

1717 S Range Line Rd
Ste B
Joplin, MO 64804
Phone (417) 556-2231

100 Mercy Way
#430
Joplin, MO 64804
Phone (417) 556-2278

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

2550 Lusk Dr
Neosho, MO 64850
Phone (417) 451-2060

Organizations & group practices 3

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 4

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": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1215287750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 E HICKORY ST",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648501806",
            "telephone_number": "417-451-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E HICKORY ST",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "648501806",
            "telephone_number": "417-451-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KIMBERLY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-12",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2012031598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neosho, MO

Sources for this page

Verify at the official NPI Registry.