Individual provider Active NPI

Phuongdinh T Nguyen, NP-C

  • Family Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1588911036
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
25479 Issued in TN
Practice address
880 Madison Ave
Memphis, TN 38103-3409
Phone
(901) 515-4991
Fax
(901) 545-8896
NPI assigned
Aug 14, 2012
Last updated
Jul 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 25479 TN Primary
Registered Nurse 163W00000X 189643 TN

Addresses

Primary practice location

880 Madison Ave
Memphis, TN 38103-3409

Mailing address

1669 Kirby Pkwy Ste 110
Memphis, TN 38120-4397
Phone (901) 755-8891

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20200101000018 TN Practitioner - Nurse Practitioner 2668806571 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut Regional One Physicians IncGroup PAC ID 5698993418, 314 clinicians

Practice addresses (Care Compare)

880 Madison Ave
Memphis, TN 38103-3409
Phone (901) 545-6969

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.97 of 100Reported as group
Quality
64.58
Improvement activities
40
Cost
77.33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Regional One Physicians Inc CurrentSince May 1, 2023 Accepting new patients
Ut Regional One Physicians Inc CurrentSince May 1, 2023 Accepting new patients
Midsouth Independent Group, PLLC CurrentSince Jan 1, 2021 Accepting new patients
Midsouth Sleep Diagnostic Center Inc PastSince Feb 12, 2023 Accepting new patients

Locations

764 Walnut Knoll Ln
Cordova, TN 38018
Phone (901) 756-5565

2245 S Lauderdale St
Memphis, TN 38106
Phone (901) 582-7660

6215 Humphreys Blvd
Ste 201
Memphis, TN 38120
Phone (901) 866-8085

880 Madison Ave
Memphis, TN 38103
Phone (901) 515-3500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1344902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1588911036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1669 KIRBY PKWY STE 110",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381204397",
            "telephone_number": "901-755-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033409",
            "telephone_number": "901-515-4991",
            "fax_number": "901-545-8896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PHUONGDINH",
        "middle_name": "T",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-14",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "25479",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "189643",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.