Individual provider Active NPI

CHI Kim Nguyen, O.D.

  • Optometrist
  • Humble, TX
National Provider Identifier
1356676928
Registry record updated Jul 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7412TG Issued in TX
Practice address
21802 Townsen Blvd W
Humble, TX 77338-1594
Phone
(832) 406-2781
Fax
(281) 205-5714
NPI assigned
Oct 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7412TG TX Primary

Addresses

Primary practice location

21802 Townsen Blvd W
Humble, TX 77338-1594

Mailing address

21802 Townsen Blvd W
Humble, TX 77338-1594
Phone (832) 406-2781

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140605001819 TX Practitioner - Optometry 6507080884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

21802 Townsen Blvd W
Humble, TX 77338-1594
Phone (281) 707-7066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7412TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nguyen & Whyte Eyecare PLLC Optometrist CurrentSince Jun 12, 2015 Accepting new patients
Neuro-Ophthalmology of Texas PLLC Past Accepting new patients

Locations

21802 Townsen Blvd W
Humble, TX 77338
Phone (281) 707-7061

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10507/brand/2/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1255564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1356676928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21802 TOWNSEN BLVD W",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773381594",
            "telephone_number": "832-406-2781",
            "fax_number": "281-205-5714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21802 TOWNSEN BLVD W",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773381594",
            "telephone_number": "832-406-2781",
            "fax_number": "281-205-5714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CHI",
        "middle_name": "KIM",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-15",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7412TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

Verify at the official NPI Registry.