NPIMap

Organization Active NPI

Jimmy Nguyen OD PA

  • Optometrist
  • Kissimmee, FL
National Provider Identifier
1821394891
Registry record updated Feb 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 4478 Issued in FL
Legal business name
JIMMY NGUYEN OD PA
Practice address
1204 N John Young Pkwy
Kissimmee, FL 34741-4206
Phone
(407) 408-5177
NPI assigned
Feb 8, 2011
Last updated
Feb 8, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2011

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

Authorized official

Name
Dr. Jimmy Nguyen, O.D.NPI 1184944985
Title
Optometrist
Phone
(407) 408-5177

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC 4478 FL Primary

Addresses

Primary practice location

1204 N John Young Pkwy
Kissimmee, FL 34741-4206

Mailing address

8037 Sandberry Blvd
Orlando, FL 32819-4184

National Provider Directory

National Provider Directory

Locations

1204 N John Young Pkwy
Kissimmee, FL 34741
Phone (407) 408-5177

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1297123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297123200000",
    "number": "1821394891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8037 SANDBERRY BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328194184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 N JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414206",
            "telephone_number": "407-408-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIMMY NGUYEN OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-08",
        "last_updated": "2011-02-08",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "407-408-5177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.