Individual provider Active NPI

Kim Thien Nguyen, NP-C

  • Gerontology Nurse Practitioner
  • Greensboro, NC
National Provider Identifier
1720457997
Registry record updated Sep 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
5007987 Issued in NC
Practice address
1309 N Elm St
Greensboro, NC 27401-1005
Phone
(336) 544-5400
NPI assigned
Sep 17, 2015
Last updated
Sep 17, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 5007987 NC Primary
Registered Nurse 163W00000X 237302 NC

Addresses

Primary practice location

1309 N Elm St
Greensboro, NC 27401-1005

Mailing address

4440 Hunter Oaks CT
High Point, NC 27265-8501
Phone (336) 772-0819

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160104000540 NC Practitioner - Nurse Practitioner 9739481003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Brody School of Medicine at East Carolina University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osh Mi Physicians Group, PCGroup PAC ID 7810282191, 154 clinicians

Practice addresses (Care Compare)

1007 Summit Ave
Greensboro, NC 27405-7007
Phone (336) 200-7010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
237302NCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Osh-Mi Physicians Group PC Gerontology CurrentSince Jul 19, 2021 Accepting new patients
Osh Mi Physicians Group, PC CurrentSince Jul 19, 2021 Accepting new patients

Locations

3250 Freedom Dr
Charlotte, NC 28208
Phone (704) 394-0118

1007 Summit Ave
Greensboro, NC 27405
Phone (336) 200-7010

Interoperability endpoints

  • Direct secure messaging: kim.nguyen@oakstreethealth.gwaydirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1720457997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 HUNTER OAKS CT",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272658501",
            "telephone_number": "336-772-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 N ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011005",
            "telephone_number": "336-544-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KIM",
        "middle_name": "THIEN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-17",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "5007987",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "237302",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.