Organization Active NPI

Duc Nguyen Podiatry LLC

  • Podiatric Clinic/Center
  • Saint Augustine, FL
National Provider Identifier
1659943546
Registry record updated Oct 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
DUC NGUYEN PODIATRY LLC
Practice address
7509 State Road 13 N
Saint Augustine, FL 32092-2230
Phone
(904) 417-8894
Fax
(877) 370-4468
NPI assigned
Jul 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2022

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

Authorized official

Name
Dr. Duc Nguyen, DPMNPI 1801278171
Title
Podiatrist
Phone
(586) 744-9584

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X Primary

Addresses

Primary practice location

7509 State Road 13 N
Saint Augustine, FL 32092-2230

Mailing address

7509 State Road 13 N
Saint Augustine, FL 32092-2230
Phone (904) 417-8894

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210824000226 FL Part B Supplier - Clinic/Group Practice 1557766946 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Augustine, FL

National Provider Directory

National Provider Directory

Locations

1820 State Road 13 N
Ste 11919
Saint Johns, FL 32259

1820 State Road 13 N
Ste 11
Saint Johns, FL 32259
Phone (904) 417-8894

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665878400000",
    "number": "1659943546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7509 STATE ROAD 13 N",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320922230",
            "telephone_number": "904-417-8894",
            "fax_number": "877-370-4468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7509 STATE ROAD 13 N",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320922230",
            "telephone_number": "904-417-8894",
            "fax_number": "877-370-4468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUC NGUYEN PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-12",
        "last_updated": "2022-10-16",
        "certification_date": "2022-10-16",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "DUC",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "586-744-9584",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.