Active NPI
Heidi Le Nguyen
- Pharmacist
- Grand Rapids, MI
National Provider Identifier
1831714005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302411716
- Practice address
- 425 Fuller Ave NE
Grand Rapids, MI 49503-1911 - Phone
- (616) 776-9925
- Fax
- (616) 776-7675
- NPI assigned
- Jun 12, 2020
- Last updated
- Nov 27, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | 5302411716 | MI | Primary |
Addresses
Primary practice location
425 Fuller Ave NE
Grand Rapids, MI 49503-1911
Mailing address
425 Fuller Ave NE
Grand Rapids, MI 49503-1911
Phone (616) 776-9925
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rxm.15007@store.walgreens.com | WALGREEN CO |
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 |
|---|---|---|---|
| 5302411716 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
425 Fuller Ave NE
Grand Rapids, MI 49503
Phone (616) 776-9925
Interoperability endpoints
- rxm.15007@store.walgreens.com
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1831714005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "425 FULLER AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495031911",
"telephone_number": "616-776-9925",
"fax_number": "616-776-7675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 FULLER AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495031911",
"telephone_number": "616-776-9925",
"fax_number": "616-776-7675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "HEIDI",
"middle_name": "LE",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-12",
"last_updated": "2023-11-27",
"certification_date": "2020-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302411716",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rxm.15007@store.walgreens.com",
"affiliation": "Y",
"endpointDescription": "work email",
"affiliationName": "WALGREEN CO",
"address_1": "425 Fuller Ave NE",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495031911",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.