Individual provider Active NPI

Tam Ngoc Ngo, PHARM.D

  • Pharmacist
  • Saint Cloud, FL
National Provider Identifier
1376146480
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS40853 Issued in FL
Practice address
3555 13TH St
Saint Cloud, FL 34769-4054
Phone
(407) 892-7161
Fax
(407) 892-5184
NPI assigned
Nov 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS40853 FL Primary

Addresses

Primary practice location

3555 13TH St
Saint Cloud, FL 34769-4054

Mailing address

3555 13TH St
Saint Cloud, FL 34769-4054
Phone (407) 892-7161

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 Pharmacy

State licenses

LicenseStateTypeSpecialty
PS40853FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Holiday CVS L.L.C. PastSince Nov 22, 2020 Accepting new patients

Organizations & group practices 1

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": "1605744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1376146480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 13TH ST",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347694054",
            "telephone_number": "407-892-7161",
            "fax_number": "407-892-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 13TH ST",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347694054",
            "telephone_number": "407-892-7161",
            "fax_number": "407-892-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO",
        "first_name": "TAM",
        "middle_name": "NGOC",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-19",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS40853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.