Individual provider Active NPI

Phuong Thi Nguyen, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Westminster, CA
National Provider Identifier
1811583073
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95011970 Issued in CA
Practice address
14501 Magnolia St
Westminster, CA 92683-1306
Phone
(714) 799-7731
NPI assigned
Dec 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95011970 CA Primary

Addresses

Primary practice location

14501 Magnolia St
Westminster, CA 92683-1306

Mailing address

3343 W Olinda LN
Anaheim, CA 92804-2723
Phone (714) 589-6874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20210927001294 CA Practitioner - Nurse Practitioner 9436556925 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kelvin Mai, D.O., Inc CurrentSince Sep 15, 2021 Accepting new patients

Locations

12666 Brookhurst St
Ste 130
Garden Grove, CA 92840
Phone (714) 332-1069

1002 N Fairview St
Santa Ana, CA 92703
Phone (714) 332-1069

Interoperability endpoints

  • Direct secure messaging: phuong.nguyen.p38@direct.monarchhealthcare.nextgenshare.com

Organizations & group practices 1

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": "1607644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1811583073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3343 W OLINDA LN",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928042723",
            "telephone_number": "714-589-6874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14501 MAGNOLIA ST",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926831306",
            "telephone_number": "714-799-7731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PHUONG",
        "middle_name": "THI",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95011970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CA

Sources for this page

Verify at the official NPI Registry.