Active NPI
Sophia Bao Nguyen, AUD
- Audiologist
- Salem, OR
National Provider Identifier
1851894604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 30896
- Practice address
- 3857 Wolverine St NE Ste 16C
Salem, OR 97305-4270 - Phone
- (503) 877-1684
- NPI assigned
- Mar 16, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist-Hearing Aid Fitter | 237600000X | 30896 | OR | |
| Audiologist | 231H00000X | 30896 | OR | Primary |
Addresses
Primary practice location
3857 Wolverine St NE Ste 16C
Salem, OR 97305-4270
Mailing address
12210 SW Kelly LN
Tigard, OR 97223-2840
Phone (503) 380-5004
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30896 | OR | MD | Audiologist-Hearing Aid Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MLM USA LLC | Audiologist | Past | Accepting new patients |
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": "1521158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521158400000",
"number": "1851894604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12210 SW KELLY LN",
"city": "TIGARD",
"state": "OR",
"postal_code": "972232840",
"telephone_number": "503-380-5004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3857 WOLVERINE ST NE STE 16C",
"city": "SALEM",
"state": "OR",
"postal_code": "973054270",
"telephone_number": "503-877-1684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "SOPHIA",
"middle_name": "BAO",
"name_prefix": "Dr.",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-16",
"last_updated": "2018-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "OR",
"license": "30896",
"primary": false
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "OR",
"license": "30896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.