Individual provider Active NPI

Thu Anh Nguyen

  • Gerontology Nurse Practitioner
  • Houston, TX
National Provider Identifier
1871154112
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
1021391 Issued in TX
Practice address
4700 W Sam Houston Pkwy N Ste 220
Houston, TX 77041-8224
Phone
(713) 402-7824
Fax
(713) 570-0196
NPI assigned
Jun 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2299206 MA
Nurse Practitioner 363L00000X RN2299206 MA
Gerontology Nurse Practitioner 363LG0600X 1021391 TX Primary

Addresses

Primary practice location

4700 W Sam Houston Pkwy N Ste 220
Houston, TX 77041-8224

Mailing address

4700 W Sam Houston Pkwy N Ste 220
Houston, TX 77041-8224
Phone (713) 402-7824

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220207000119 TX Practitioner - Nurse Practitioner 5395138820 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2299206MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA CurrentSince Aug 21, 2024 Accepting new patients
Wellmed Medical Group, P.a. CurrentSince Aug 21, 2024 Accepting new patients

Locations

4700 W Sam Houston Pkwy N
Ste 220
Houston, TX 77041
Phone (713) 402-7824

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

Interoperability endpoints

  • Direct secure messaging: thnguyen@landmarkhealth-direct.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1871154112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 W SAM HOUSTON PKWY N STE 220",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770418224",
            "telephone_number": "713-402-7824",
            "fax_number": "713-570-0196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 W SAM HOUSTON PKWY N STE 220",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770418224",
            "telephone_number": "713-402-7824",
            "fax_number": "713-570-0196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THU",
        "middle_name": "ANH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-26",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2299206",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2299206",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1021391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.