Active NPI
Kevin Nguyen
- Pharmacist
- Wyoming, MI
National Provider Identifier
1801379425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302042830
- Practice address
- 5575 Byron Center Ave SW
Wyoming, MI 49519-9603 - Phone
- (616) 534-5175
- NPI assigned
- Sep 10, 2018
- Last updated
- Sep 10, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302042830 | MI | Primary |
Addresses
Primary practice location
5575 Byron Center Ave SW
Wyoming, MI 49519-9603
Mailing address
6162 Arrowcrest CT NE
Rockford, MI 49341-7368
Phone (616) 951-2775
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302042830 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
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.
-
- Pharmacy
- Wyoming, MI
- NPI 1225215254
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536537600000",
"number": "1801379425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6162 ARROWCREST CT NE",
"city": "ROCKFORD",
"state": "MI",
"postal_code": "493417368",
"telephone_number": "616-951-2775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5575 BYRON CENTER AVE SW",
"city": "WYOMING",
"state": "MI",
"postal_code": "495199603",
"telephone_number": "616-534-5175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "KEVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-10",
"last_updated": "2018-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302042830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wyoming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.