Active NPI
Ngoc Bao Nguyen, RPH
- Pharmacist
- Boise, ID
National Provider Identifier
1417653239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P10460
- Practice address
- 1515 W State St
Boise, ID 83702-4039 - Phone
- (208) 345-7684
- NPI assigned
- Feb 2, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P10460 | ID | Primary |
Addresses
Primary practice location
1515 W State St
Boise, ID 83702-4039
Mailing address
2015 S Hudson Ave Apt E104
Boise, ID 83705-4256
Phone (661) 854-6432
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P10460 | ID | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675296000000",
"number": "1417653239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2015 S HUDSON AVE APT E104",
"city": "BOISE",
"state": "ID",
"postal_code": "837054256",
"telephone_number": "661-854-6432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 W STATE ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837024039",
"telephone_number": "208-345-7684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "NGOC",
"middle_name": "BAO",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-02",
"last_updated": "2023-02-02",
"certification_date": "2023-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P10460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.