Individual provider Active NPI

Kim Khuyen Thi Nguyen, NP

  • Adult Health Nurse Practitioner
  • Encinitas, CA
National Provider Identifier
1487401659
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
95030297 Issued in CA
Practice address
781 Garden View CT Ste 100
Encinitas, CA 92024-2481
Phone
(760) 783-0441
NPI assigned
May 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 95134489 CA
Adult Health Nurse Practitioner 363LA2200X 95030297 CA Primary

Addresses

Primary practice location

781 Garden View CT Ste 100
Encinitas, CA 92024-2481

Mailing address

781 Garden View CT Ste 100
Encinitas, CA 92024-2481
Phone (760) 783-0441

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240916001388 CA Practitioner - Nurse Practitioner 9739620964 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95134489CAMDGeneral Practice Registered Nurse
95030297CAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Healthcare Partners PC CurrentSince Sep 1, 2024 Accepting new patients

Locations

354 Santa Fe Dr
Encinitas, CA 92024
Phone (760) 230-2251

781 Garden View Ct
Ste 100
Encinitas, CA 92024
Phone (760) 635-5972

9850 Genesee Ave
Ste 440
La Jolla, CA 92037
Phone (858) 453-5944

Organizations & group practices 1

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": "1714780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1487401659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "781 GARDEN VIEW CT STE 100",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242481",
            "telephone_number": "760-783-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 GARDEN VIEW CT STE 100",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242481",
            "telephone_number": "760-783-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KIM KHUYEN",
        "middle_name": "THI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-04",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "95134489",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95030297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.