NPIMap

Individual provider Active NPI

Stephanie Thanh Nguyen, PA

  • Physician Assistant
  • Dover, DE
National Provider Identifier
1659910693
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C5-0011470 Issued in DE
Practice address
793 S Queen St
Dover, DE 19904-3568
Phone
(302) 744-9310
Fax
(302) 744-9312
NPI assigned
Dec 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C5-0011470 DE Primary

Addresses

Primary practice location

793 S Queen St
Dover, DE 19904-3568

Mailing address

3002 Spruce CT
Dover, DE 19901-7922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230516003039 NC Practitioner - Physician Assistant 9638586761 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Atrium Health Specialty Network IncGroup PAC ID 5193245801, 248 clinicians

Practice addresses (Care Compare)

101 E W T Harris Blvd
Charlotte, NC 28262-3485
Phone (704) 863-5401

4525 Cameron Valley Pkwy
Charlotte, NC 28211-4369
Phone (704) 468-8874

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Atrium Health University City Hospital, Charlotte, NC, CCN 340166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince May 1, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince May 1, 2023 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince May 1, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince May 1, 2023 Accepting new patients

Locations

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

4525 Cameron Valley Pkwy
Charlotte, NC 28211
Phone (704) 355-5100

Interoperability endpoints

  • Direct secure messaging: snguyen1199877@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 7

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": "1576886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1659910693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3002 SPRUCE CT",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199017922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "793 S QUEEN ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199043568",
            "telephone_number": "302-744-9310",
            "fax_number": "302-744-9312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "STEPHANIE",
        "middle_name": "THANH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-21",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0011470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.