Jennifer Kim Nguyen, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

9215T Issued in TX

Practice address

3863 E 42ND St
Odessa, TX 79762-5947

Phone

(432) 363-9974

NPI assigned

Jun 24, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ifocus Vision LLC

  • Optometrist
  • Katy, TX
  • NPI 1811503832
  Medicare reassignment NPD

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

{
    "created_epoch": "1498262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498262400000",
    "number": "1730609355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 OAKBLUFF DR",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750071604",
            "telephone_number": "469-867-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3863 E 42ND ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797625947",
            "telephone_number": "432-363-9974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JENNIFER",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-24",
        "last_updated": "2017-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9215T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guy Loic Nguefang Tchoukeu
• Andrew Anh Nguyen, DMD
• Anh Nguyen
• Huy M Nguyen, RPH
• Jaimie Vu Nguyen
• Phong Tien Nguyen, D.O.
• Truc Trung Nguyen, MD
• Vinh H. Nguyen, M.D
• Miranda Nhoy, PA-C
• Charles C Nicolette, MD

• Optometrist in Odessa, TX
• Providers in Odessa, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.