Individual provider Active NPI

John Phuoc Nguyen

  • Family Nurse Practitioner
  • Fort Campbell, KY
National Provider Identifier
1851879753
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-78164-072 Issued in KS
Practice address
Blanchfield Army Community Hospital
650 Joel Dr
Fort Campbell, KY 42223-5318
Phone
(270) 412-8940
NPI assigned
Aug 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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 53-78164-072 KS Primary

Addresses

Primary practice location

Blanchfield Army Community Hospital
650 Joel Dr
Fort Campbell, KY 42223-5318

Mailing address

Blanchfield Army Community Hospital
650 Joel Dr
Fort Campbell, KY 42223-5318
Phone (270) 412-8940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20180912003246 KS Practitioner - Nurse Practitioner 1759631732 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53-78164-072KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergent Care Plus of Overland Park, LLC CurrentSince Mar 8, 2023 Accepting new patients
Signify Health Medical Associates of Kansas LLC CurrentSince Jan 19, 2023 Accepting new patients
Emergent Care Plus, LLC Past Accepting new patients

Locations

1100 N 4th St
Leavenworth, KS 66048
Phone (913) 297-9945

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1533168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1851879753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BLANCHFIELD ARMY COMMUNITY HOSPITAL",
            "address_2": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-412-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLANCHFIELD ARMY COMMUNITY HOSPITAL",
            "address_2": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-412-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JOHN",
        "middle_name": "PHUOC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-02",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-78164-072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Campbell, KY

Sources for this page

Verify at the official NPI Registry.