NPIMap

Individual provider Active NPI

Kim Phung Thi Nguyen, PHARM D

  • Pharmacist
  • Gretna, LA
National Provider Identifier
1700144102
Registry record updated Sep 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PST.019928 Issued in LA
Practice address
120 Meadowcrest St
Suite 150
Gretna, LA 70056-5255
Phone
(504) 393-7733
NPI assigned
Apr 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PST.019928 LA Primary
Pharmacist 183500000X E-12736 MS

Addresses

Primary practice location

120 Meadowcrest St
Suite 150
Gretna, LA 70056-5255

Mailing address

120 Meadowcrest St
Suite 150
Gretna, LA 70056-5255
Phone (504) 393-7733

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
PST.019928LAMDPharmacist
E-12736MSMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Plaza Pharmacy Inc Past Accepting new patients

Organizations & group practices 1

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": "1335225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379030400000",
    "number": "1700144102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MEADOWCREST ST",
            "address_2": "SUITE 150",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700565255",
            "telephone_number": "504-393-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MEADOWCREST ST",
            "address_2": "SUITE 150",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700565255",
            "telephone_number": "504-393-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KIM PHUNG",
        "middle_name": "THI",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-24",
        "last_updated": "2013-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "PST.019928",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E-12736",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gretna, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; 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.