Dr Kim Anh Nguyen LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

DR KIM ANH NGUYEN LLC

Practice address

5920 S Rainbow Blvd Ste 5
Las Vegas, NV 89118-4209

Phone

(702) 763-2002

Fax

(877) 414-2638

NPI assigned

Jul 9, 2021

Organization subpart

No

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

Authorized official

Name

Kim Anh Nguyen, DONPI 1700030954

Title

Medical Director/Owner

Phone

(702) 763-2002

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Dr. Kim Nguyen, DO Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kim Anh Nguyen, D.O.

  • Surgery Physician
  • Las Vegas, NV
  • NPI 1700030954

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679961600000",
    "number": "1871164855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 S RAINBOW BLVD STE 5",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891184209",
            "telephone_number": "702-763-2002",
            "fax_number": "877-414-2638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 S RAINBOW BLVD STE 5",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891184209",
            "telephone_number": "702-763-2002",
            "fax_number": "877-414-2638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 N Gibson Rd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890111708",
            "country_code": "US",
            "telephone_number": "702-763-2002",
            "fax_number": "877-414-2638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR KIM ANH NGUYEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-09",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "ANH",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/OWNER",
        "authorized_official_telephone_number": "702-763-2002",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871164855",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700030954",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "DO2258",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Kim Nguyen, DO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Surgery Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Surgery Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.