Individual provider Active NPI

Thao Thi Phuong Nguyen, D.C.

  • Chiropractor
  • Lees Summit, MO
National Provider Identifier
1609289388
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2014013452 Issued in MO
Practice address
931 SW Lemans LN
Lees Summit, MO 64082-4619
Phone
(816) 623-3020
Fax
(816) 623-3076
NPI assigned
Jun 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2014013452 MO Primary
Chiropractor 111N00000X 01-05624 KS

Addresses

Primary practice location

931 SW Lemans LN
Lees Summit, MO 64082-4619

Mailing address

931 SW Lemans LN
Lees Summit, MO 64082-4619
Phone (816) 232-5113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140701000371 MO Practitioner - Chiropractic 5799900049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raintree Medical and Chiropractic Center LLCGroup PAC ID 5991025447, 3 clinicians

Practice addresses (Care Compare)

931 SW Lemans LN
Lees Summit, MO 64082-4619
Phone (816) 623-3020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2014013452MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Raintree Medical and Chiropractic Center LLC CurrentSince Jan 1, 2017 Accepting new patients

Locations

931 SW Lemans Ln
Lees Summit, MO 64082
Phone (816) 623-3020

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": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1609289388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 SW LEMANS LN",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640824619",
            "telephone_number": "816-232-5113",
            "fax_number": "816-232-0453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 SW LEMANS LN",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640824619",
            "telephone_number": "816-623-3020",
            "fax_number": "816-623-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THAO",
        "middle_name": "THI PHUONG",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-10",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2014013452",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05624",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.