Individual provider Active NPI

Rosa Phuongchi Nguyen, FNP

  • Family Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1437405248
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2012025989 Issued in MO
Practice address
1230 E Kingsley St Ste a&B
Springfield, MO 65804-7211
Phone
(417) 336-0033
Fax
(855) 710-6552
NPI assigned
Jul 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2012025989 MO Primary

Addresses

Primary practice location

1230 E Kingsley St Ste a&B
Springfield, MO 65804-7211

Mailing address

110 Business Park Dr Ste C
Branson, MO 65616-7449
Phone (417) 336-0033

Other practice location 1

110 Business Park Dr Ste C
Branson, MO 65616-7449
Phone (417) 336-0033

Other identifiers 1

IdentifierTypeStateIssuer
1437405248MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20120821000699 MO Practitioner - Nurse Practitioner 8123275419 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology and Mohs Surgery Skin Cancer CenterGroup PAC ID 8527447945, 8 clinicians

Practice addresses (Care Compare)

1230 E Kingsley St
Suite Aandb
Springfield, MO 65804-7211
Phone (417) 336-0033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology and Mohs Surgery Skin Cancer Center CurrentSince Apr 1, 2024 Accepting new patients
Lester E Cox Medical Centers CurrentSince Aug 21, 2012 Accepting new patients
Lester E Cox Medical Centers Current Accepting new patients
Lester E Cox Medical Centers Family CurrentSince Aug 21, 2012 Accepting new patients

Locations

110 Business Park Dr
Ste C
Branson, MO 65616
Phone (417) 239-0125

914 Alexis
Lebanon, MO 65536
Phone (417) 336-0033

10101 Stoltz Dr
Rolla, MO 65401
Phone (417) 336-0033

3801 S National Ave
Ste 1122
Springfield, MO 65807

1230 E Kingsley St
Ste Ab
Springfield, MO 65804
Phone (417) 336-0033

2750 S Campbell Ave
Springfield, MO 65807
Phone (417) 269-2281

1230 E Kingsley St
Ste A
Springfield, MO 65804
Phone (417) 720-4916

2021 E Independence St
Springfield, MO 65804
Phone (417) 885-1445

Interoperability endpoints

  • Direct secure messaging: rosa.nguyen@cernerdirect.coxhealth.com

Organizations & group practices 4

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": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1437405248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BUSINESS PARK DR STE C",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656167449",
            "telephone_number": "417-336-0033",
            "fax_number": "855-710-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 E KINGSLEY ST STE A&B",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658047211",
            "telephone_number": "417-336-0033",
            "fax_number": "855-710-6552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Business Park Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Branson",
            "state": "MO",
            "postal_code": "656167449",
            "country_code": "US",
            "telephone_number": "417-336-0033",
            "fax_number": "855-710-6552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ROSA",
        "middle_name": "PHUONGCHI",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-30",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2012025989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437405248",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.