Kevin Nguyen

Primary specialty

OptometristTaxonomy code 152W00000X

License

OCP5708 Issued in FL

Practice address

5566 Thomaston Rd
Macon, GA 31220-8118

Phone

(478) 476-8868

NPI assigned

Jul 7, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1562457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600560000000",
    "number": "1215599667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4708 TOWN N COUNTRY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336154525",
            "telephone_number": "813-507-5092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5566 THOMASTON RD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312208118",
            "telephone_number": "478-476-8868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2181 Orange Ave E",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323116144",
            "country_code": "US",
            "telephone_number": "813-507-5092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KEVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-07",
        "last_updated": "2020-09-20",
        "certification_date": "2020-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OCP5708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Macon, GA
• Providers in Macon, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2020; 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.