Jimmy Diep Nguyen, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

ME158900 Issued in FL

Practice address

11215 Metro Pkwy Ste 1
Fort Myers, FL 33966-1206

Phone

(239) 208-2212

NPI assigned

Nov 14, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, AZ, SC, MS, NH, GA, OR7 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 7

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 26)

Interoperability endpoints

• Direct secure messaging: jnguyen863481@direct.ketteringhealth.org
• Direct secure messaging: jnguyen768551@direct.emplifyhealth.org

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.

• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272
  Medicare reassignment NPD
• Legacy Salmon Creek Hospital

  • Clinic/Center
  • Vancouver, WA
  • NPI 1356357784
  Medicare reassignment NPD
• North Mississippi Medical Center Inc

  • Psychologist
  • Tupelo, MS
  • NPI 1972608347
  Medicare reassignment NPD
• Piedmont Athens Hospitalist Physicians LLC

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1578079000
  Medicare reassignment NPD
• Piedmont Hospitalist Physicians LLC

  • Family Medicine Physician
  • Stockbridge, GA
  • NPI 1548219660
  Medicare reassignment NPD
• Silverton Health

  • General Acute Care Hospital
  • Silverton, OR
  • NPI 1669424354
  Medicare reassignment NPD
• St Joseph Hospital of Nashua NH

  • General Acute Care Hospital
  • Nashua, NH
  • NPI 1093787384
  Medicare reassignment NPD
• Upson County Hospital Inc

  • General Acute Care Hospital
  • Thomaston, GA
  • NPI 1659376630

  Neurology

  Medicare reassignment NPD
• Virtual Neurology New Jersey LLC

  • Neurology Physician
  • Fort Myers, FL
  • NPI 1972368165
  NPD
• Concord Hospital-Franklin

  • Critical Access Hospital
  • Franklin, NH
  • NPI 1700960895
  NPD
• Concord Hospital-Laconia

  • Family Medicine Physician
  • Laconia, NH
  • NPI 1053993741
  NPD
• Good Samaritan Hospital Medical

  • Critical Care Medicine (Internal Medicine) Physician
  • West Islip, NY
  • NPI 1548501620
  NPD

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1285815605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11215 METRO PKWY STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661206",
            "telephone_number": "239-208-2212",
            "fax_number": "239-220-8399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11215 METRO PKWY STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661206",
            "telephone_number": "239-208-2212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3507 S Mercy Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852970441",
            "country_code": "US",
            "telephone_number": "804-926-0644",
            "fax_number": "480-926-0645",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 26th St S",
            "address_purpose": "LOCATION",
            "city": "Great Falls",
            "state": "MT",
            "postal_code": "594055161",
            "country_code": "US",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8318",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2790 Clay Edwards Dr Ste 1235",
            "address_purpose": "LOCATION",
            "city": "North Kansas City",
            "state": "MO",
            "postal_code": "641163276",
            "country_code": "US",
            "telephone_number": "816-472-5157",
            "fax_number": "816-472-7201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JIMMY",
        "middle_name": "DIEP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-14",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2022049104",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MT",
            "license": "114802",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NM",
            "license": "MD2008-0758",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD 00049262",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "37664",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME158900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NGM Wellness Inc.
• Alan Manh-Tuong Nguyen, DO
• Anh Nguyen, PHARMD
• David Nguyen, DC
• Huy Nguyen
• Katty Nguyen, OD
• Mary Nguyen
• Paul Nguyen
• Thuong Nguyen, OD
• Thy A Nguyen, O.D.

• Neurology Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Neurology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.