Individual provider Active NPI

Xuan T Nguyen, REGISTERED DIETITIAN

  • Registered Dietitian
  • Broken Arrow, OK
National Provider Identifier
1538794813
Registry record updated Mar 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
1906 N Aster PL
Broken Arrow, OK 74012-1376
Phone
(682) 559-8152
NPI assigned
Mar 7, 2020
Last updated
Mar 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X OK Primary

Addresses

Primary practice location

1906 N Aster PL
Broken Arrow, OK 74012-1376

Mailing address

1906 N Aster PL
Broken Arrow, OK 74012-1376
Phone (682) 559-8152

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220624002200 OK Practitioner - Registered Dietitian Or Nutrition Professional 6305225103 Reassigns benefits to 1 organization
I20220627002666 TX Practitioner - Registered Dietitian Or Nutrition Professional 6305225103 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

Practice roles

OrganizationSpecialtyStatusNew patients
American Health Assessments LLC Dietitian, Registered CurrentSince Jun 15, 2022 Accepting new patients
Mobile Medical Consultants, PLLC Past Accepting new patients

Locations

3030 N West Expy
Ste 200B
Oklahoma City, OK 73112
Phone (309) 665-0206

2800 Shoreline Dr
Ste 120
Denton, TX 76210
Phone (940) 383-1240

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1583539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583539200000",
    "number": "1538794813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 N ASTER PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740121376",
            "telephone_number": "682-559-8152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 N ASTER PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740121376",
            "telephone_number": "682-559-8152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "XUAN",
        "middle_name": "T",
        "credential": "REGISTERED DIETITIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-07",
        "last_updated": "2020-03-07",
        "certification_date": "2020-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2020; 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.