Individual provider Active NPI

Pauline Nguyen, ANP

  • Adult Health Nurse Practitioner
  • Southlake, TX
National Provider Identifier
1336419720
Registry record updated Mar 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP120303 Issued in TX
Practice address
505 S Nolen Dr
Suite a
Southlake, TX 76092-9167
Phone
(817) 424-1525
Fax
(817) 424-3491
NPI assigned
Jan 3, 2012
Last updated
Mar 6, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 791946 TX
Adult Health Nurse Practitioner 363LA2200X AP120303 TX Primary

Addresses

Primary practice location

505 S Nolen Dr
Suite a
Southlake, TX 76092-9167

Mailing address

PO Box 35629
Dallas, TX 75235-0629
Phone (214) 424-2200

Other identifiers 2

IdentifierTypeStateIssuer
AP120303OtherTXAPRN LICENSE
791946OtherTXRN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120712000290 TX Practitioner - Nurse Practitioner 8426213711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
66.51
Promoting interoperability
98
Improvement activities
40
Cost
71.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP120303TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Digestive Disease Consultants, PLLC Current Accepting new patients
Texas Digestive Disease Consultants PLLC CurrentSince Apr 1, 2015 Accepting new patients
Texas Digestive Disease Consultants, PLLC CurrentSince Apr 1, 2015 Accepting new patients
Specialists in Advanced Gastroenterology and Endoscopy, PLLC Past Accepting new patients
Joycelyn M. Theard M.D,P.a. Past Accepting new patients
Texas Digestive Disease Consultants, PLLC Past Accepting new patients

Locations

4370 Medical Arts Dr
Ste 295
Flower Mound, TX 75028
Phone (972) 691-3777

701 Tuscan Dr
Ste 110
Irving, TX 75039
Phone (214) 496-1100

601 S Main St
Keller, TX 76248
Phone (817) 741-4347

5425 W Spring Creek Pkwy
Ste 205
Plano, TX 75024
Phone (972) 526-5860

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425600000000",
    "number": "1336419720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35629",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752350629",
            "telephone_number": "214-424-2200",
            "fax_number": "214-231-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S NOLEN DR",
            "address_2": "SUITE A",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929167",
            "telephone_number": "817-424-1525",
            "fax_number": "817-424-3491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PAULINE",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-03",
        "last_updated": "2015-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "791946",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP120303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "AP120303",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "791946",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

Verify at the official NPI Registry.