Active NPI
Kim Nguyen
- Nutrition Chiropractor
- San Jose, CA
National Provider Identifier
1649624107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Chiropractor
- License
- 1235467
- Practice address
- 4841 Birmingham Dr
San Jose, CA 95136-2907 - Phone
- (408) 456-1237
- NPI assigned
- Apr 20, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Chiropractor | 111NN1001X | 1235467 | CA | Primary |
Addresses
Primary practice location
4841 Birmingham Dr
San Jose, CA 95136-2907
Mailing address
4841 Birmingham Drive
San Jose, CA 95136
Phone (408) 123-4567
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1235467 | CA | MD | Nutrition Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493942400000",
"number": "1649624107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4841 BIRMINGHAM DRIVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95136",
"telephone_number": "408-123-4567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4841 BIRMINGHAM DR",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951362907",
"telephone_number": "408-456-1237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "KIM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-20",
"last_updated": "2017-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "111NN1001X",
"taxonomy_group": "",
"desc": "Chiropractor, Nutrition",
"state": "CA",
"license": "1235467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.