Individual provider Active NPI

Hoang Ton Nguyen, AGNP

  • Adult Health Nurse Practitioner
  • Prescott, AZ
National Provider Identifier
1790333706
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
265870 Issued in AZ
Practice address
1001 Willow Creek Rd Ste 2200
Prescott, AZ 86301-1614
Phone
(928) 445-6025
Fax
(928) 778-3026
NPI assigned
Sep 3, 2019
Last updated
Feb 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 265870 AZ Primary

Addresses

Primary practice location

1001 Willow Creek Rd Ste 2200
Prescott, AZ 86301-1614

Mailing address

PO Box 10880
Prescott, AZ 86304-0880
Phone (602) 406-4786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20220329002217 AZ Practitioner - Nurse Practitioner 5294151148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1001 Willow Creek Rd
Suite 2200
Prescott, AZ 86301-1614
Phone (928) 445-6025

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
265870AZMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Yavapai Regional Medical Center Physician Care LLC CurrentSince Dec 17, 2021 Accepting new patients
Yavapai Regional Medical Center Physician Care LLC Cardiovascular Disease Current Accepting new patients
Yavapai Regional Medical Center Physician Care LLC Cardiovascular Disease CurrentSince Dec 17, 2021 Accepting new patients

Locations

1001 Willow Creek Rd
Ste 2200
Prescott, AZ 86301
Phone (928) 445-6025

3120 Clearwater Dr
Prescott, AZ 86305
Phone (928) 445-4818

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1790333706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10880",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863040880",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 WILLOW CREEK RD STE 2200",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011614",
            "telephone_number": "928-445-6025",
            "fax_number": "928-778-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "HOANG",
        "middle_name": "TON",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-03",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "265870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.