Active NPI
Ngoc-Ha Thi Nguyen MD PC
- Internal Medicine Physician
- Annandale, VA
National Provider Identifier
1396795605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 0101053981
- Legal business name
- NGOC-HA THI NGUYEN MD PC
- Practice address
- 7202C Poplar St
Annandale, VA 22003 - Phone
- (703) 642-3220
- Fax
- (703) 778-9863
- NPI assigned
- May 10, 2006
- Last updated
- Mar 11, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Ngoc Ha Thi Nguyen, MD
- Title
- President
- Phone
- (703) 642-3220
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0101053981 | VA | Primary |
Addresses
Primary practice location
7202C Poplar St
Annandale, VA 22003
Mailing address
PO Box 1645
Annandaue, VA 22003
Phone (703) 642-3220
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 490895 | Other | VA | MEDICARE PTAN |
| 5852340 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
7202 Poplar St
Ste C
Annandale, VA 22003
Phone (703) 642-3220
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1710115200000",
"number": "1396795605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1645",
"city": "ANNANDAUE",
"state": "VA",
"postal_code": "22003",
"telephone_number": "703-642-3220",
"fax_number": "703-778-9863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7202C POPLAR ST",
"city": "ANNANDALE",
"state": "VA",
"postal_code": "22003",
"telephone_number": "703-642-3220",
"fax_number": "703-778-9863"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NGOC-HA THI NGUYEN MD PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-10",
"last_updated": "2024-03-11",
"certification_date": "2024-03-11",
"status": "A",
"authorized_official_last_name": "NGUYEN",
"authorized_official_first_name": "NGOC HA",
"authorized_official_middle_name": "THI",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "703-642-3220",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "VA",
"license": "0101053981",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "490895",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5852340",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Annandale, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.