Individual provider Active NPI

Hieu CHI Nguyen, PHARMD

  • Pharmacist
  • Port St Lucie, FL
National Provider Identifier
1609417245
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS54052 Issued in FL
Practice address
1954 SW Gatlin Blvd
Port St Lucie, FL 34953-2722
Phone
(772) 224-3020
Fax
(772) 878-9388
NPI assigned
Oct 4, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS54052 FL Primary

Addresses

Primary practice location

1954 SW Gatlin Blvd
Port St Lucie, FL 34953-2722

Mailing address

2673 SE Bikas LN
Port Saint Lucie, FL 34952-7114
Phone (646) 662-4626

Other practice location 1

1705 US 1
Vero Beach, FL 32960-5544
Phone (772) 569-1414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS54052FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Dec 28, 2022 Accepting new patients
Walgreen Co PastSince Oct 1, 2019 Accepting new patients
Walgreen Co PastSince Oct 1, 2019 Accepting new patients

Locations

1954 SW Gatlin Blvd
Port St Lucie, FL 34953
Phone (772) 224-3020

Organizations & group practices 3

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": "1570147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1609417245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2673 SE BIKAS LN",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349527114",
            "telephone_number": "646-662-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1954 SW GATLIN BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349532722",
            "telephone_number": "772-224-3020",
            "fax_number": "772-878-9388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1705 US 1",
            "address_purpose": "LOCATION",
            "city": "Vero Beach",
            "state": "FL",
            "postal_code": "329605544",
            "country_code": "US",
            "telephone_number": "772-569-1414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "HIEU",
        "middle_name": "CHI",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-04",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS54052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.