Active NPI
Kim Phuong Thi Nguyen, PHARMD
- Oncology Pharmacist
- Fayetteville, GA
National Provider Identifier
1487102174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oncology Pharmacist
- License
- 025736
- Practice address
- 132 Old Norton Rd Ste 200
Fayetteville, GA 30215-4873 - Phone
- (678) 817-1117
- NPI assigned
- Sep 12, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Oncology Pharmacist | 1835X0200X | 025736 | GA | Primary |
Addresses
Primary practice location
132 Old Norton Rd Ste 200
Fayetteville, GA 30215-4873
Mailing address
115 Chablis CT
Fayetteville, GA 30214-7120
Phone (404) 825-0989
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
| License | State | Type | Specialty |
|---|---|---|---|
| 025736 | GA | MD | Oncology Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473638400000",
"number": "1487102174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 CHABLIS CT",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302147120",
"telephone_number": "404-825-0989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "132 OLD NORTON RD STE 200",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302154873",
"telephone_number": "678-817-1117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "KIM PHUONG",
"middle_name": "THI",
"name_prefix": "Ms.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-12",
"last_updated": "2016-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "1835X0200X",
"taxonomy_group": "",
"desc": "Pharmacist, Oncology",
"state": "GA",
"license": "025736",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.