Individual provider Active NPI

Stephanie Giang-Tien Nguyen, DO

  • Pediatrics Physician
  • Fairfax, VA
National Provider Identifier
1366016149
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0102208598 Issued in VA
Practice address
13135 Route 50 Ste 201
Fairfax, VA 22033-1907
Phone
(703) 391-0900
NPI assigned
May 17, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 0102208598 VA Primary

Addresses

Primary practice location

13135 Route 50 Ste 201
Fairfax, VA 22033-1907

Mailing address

86 W Underwood St Ste 202
Orlando, FL 32806-1110
Phone (407) 649-6876

Other practice location 1

51 Pennsylvania St
Orlando, FL 32806-2937
Phone (321) 843-3220

Other practice location 2

92 W Miller St
Orlando, FL 32806-2032
Phone (407) 649-6876

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://www.orlandohealth.com/pediatric-residency

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102208598VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trusted Doctors LLC Pediatrics Past Accepting new patients
Orlando Health Medical Group Inc Pediatrics PastSince May 25, 2021 Accepting new patients

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": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1366016149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 W UNDERWOOD ST STE 202",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061110",
            "telephone_number": "407-649-6876",
            "fax_number": "407-872-0544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13135 ROUTE 50 STE 201",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331907",
            "telephone_number": "703-391-0900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51 Pennsylvania St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328062937",
            "country_code": "US",
            "telephone_number": "321-843-3220",
            "fax_number": "321-843-3210",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "92 W Miller St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328062032",
            "country_code": "US",
            "telephone_number": "407-649-6876",
            "fax_number": "407-872-0544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "STEPHANIE",
        "middle_name": "GIANG-TIEN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-17",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0102208598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.orlandohealth.com/pediatric-residency",
            "affiliation": "N",
            "endpointDescription": "Pediatric Residency Program",
            "address_1": "92 W Miller St",
            "city": "Orlando",
            "state": "FL",
            "country_code": "US",
            "postal_code": "328062032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.