Individual provider Active NPI

Duy Nguyen, PHARMD

  • Pharmacist
  • Jacksonville, FL
National Provider Identifier
1629670492
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS56210 Issued in FL
Practice address
11757 Beach Blvd Ste 7
Jacksonville, FL 32246-6633
Phone
(904) 531-4556
Fax
(904) 531-4556
NPI assigned
Nov 16, 2020
Last updated
Nov 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS56210 FL Primary

Addresses

Primary practice location

11757 Beach Blvd Ste 7
Jacksonville, FL 32246-6633

Mailing address

5350 Arlington Expy Apt 4604
Jacksonville, FL 32211-6844

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
PS56210FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kumu Health Inc. CurrentSince Apr 10, 2022 Accepting new patients
Public Square Pharmacy LLC PastSince Nov 22, 2020 Accepting new patients

Locations

11757 Beach Blvd
Ste 7
Jacksonville, FL 32246
Phone (904) 531-4556

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": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1629670492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 ARLINGTON EXPY APT 4604",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322116844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11757 BEACH BLVD STE 7",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322466633",
            "telephone_number": "904-531-4556",
            "fax_number": "904-531-4556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DUY",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-16",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS56210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.