Tam Nguyen OD PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

TAM NGUYEN OD PLLC

Practice address

3850 Conlon Way Ste F
Elizabeth City, NC 27909-7665

Phone

(252) 512-5004

Fax

(252) 888-1442

NPI assigned

Sep 1, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Tam T Nguyen, ODNPI 1689197568

Title

Optometrist/Owner

Phone

(252) 512-5004

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Visionary Eye Care Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tam Nguyen, OD

  • Optometrist
  • Chesapeake, VA
  • NPI 1689197568

  NC, Optometrist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1567296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1508414616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 CONLON WAY STE F",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279097665",
            "telephone_number": "252-512-5004",
            "fax_number": "252-888-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 CONLON WAY STE F",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279097665",
            "telephone_number": "252-512-5004",
            "fax_number": "252-888-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAM NGUYEN OD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-01",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "TAM",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "252-512-5004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRY LICENSE NUMBER",
            "identifier": "0618002584",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Visionary Eye Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Visionary Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Elizabeth City, NC
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.