Kieu Thy Duong

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4272 Timber Jump CV
Memphis, TN 38141-7353

Phone

(901) 550-3414

NPI assigned

Jun 29, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

California Dermatology Institute PCGroup PAC ID 6800177460, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• California Dermatology Institute PC

  • Dermatology Physician
  • Thousand Oaks, CA
  • NPI 1235671389
  Medicare reassignment Care Compare group
• California Rheumatology Institute Inc

  • Rheumatology Physician
  • Huntington Park, CA
  • NPI 1326857772
  NPD (past)

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1407588296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4272 TIMBER JUMP CV",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381417353",
            "telephone_number": "901-550-3414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4272 TIMBER JUMP CV",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381417353",
            "telephone_number": "901-550-3414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUONG",
        "first_name": "KIEU",
        "middle_name": "THY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chanda Michelle Lee Dunn, LCSW
• David Wayne Dunn, D.PH
• Julia Yi Dunn
• William Donald Dunn, PHARM.D.
• Sharon Dunseath, PTA
• Wynne Duong, AGACNP-BC
• Thieu Quoc Dupre, PHARMD
• Breisha Dupree
• Walter Gramlin Dupree Jr., CTRS
• Genevieve C Dupuis, CRNA

• Physician Assistant in Memphis, TN
• Providers in Memphis, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.