Individual provider Active NPI

Quoi Quyen Nguyen, M.D

  • Family Medicine Physician
  • Macclenny, FL
National Provider Identifier
1720179757
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
73538 Issued in FL
Practice address
7487 S State Road 121
Macclenny, FL 32063-5451
Phone
(904) 259-6211
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 73538 FL Primary

Addresses

Primary practice location

7487 S State Road 121
Macclenny, FL 32063-5451

Mailing address

4467 Summer Haven Blvd S
Jacksonville, FL 32258-1450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
73538FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Children and Families Current Accepting new patients
Florida Department of Children and Families CurrentSince Feb 5, 2021 Accepting new patients

Locations

7487 S State Road 121
Macclenny, FL 32063
Phone (904) 259-6211

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720179757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4467 SUMMER HAVEN BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322581450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7487 S STATE ROAD 121",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320635451",
            "telephone_number": "904-259-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "QUOI",
        "middle_name": "QUYEN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "73538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macclenny, FL

Sources for this page

Verify at the official NPI Registry.