Active NPI
Kevin Van Nguyen, RPH
- Pharmacist
- Worcester, MA
National Provider Identifier
1871259309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH240526
- Practice address
- 99 Stafford St
Worcester, MA 01603-1456 - Phone
- (508) 797-6401
- NPI assigned
- Nov 9, 2021
- Sex
- Male
- Sole proprietor
- No
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 | PH240526 | MA | Primary |
Addresses
Primary practice location
99 Stafford St
Worcester, MA 01603-1456
Mailing address
99 Stafford St
Worcester, MA 01603-1456
Phone (508) 797-6401
Other practice location 1
472 Lincoln St
Worcester, MA 01605-1917
Phone (508) 856-7923
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH240526 | MA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
472 Lincoln St
Worcester, MA 01605
Phone (508) 856-7923
99 Stafford St
Worcester, MA 01603
Phone (508) 797-6401
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": "1636416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672876800000",
"number": "1871259309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 STAFFORD ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016031456",
"telephone_number": "508-797-6401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 STAFFORD ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016031456",
"telephone_number": "508-797-6401"
}
],
"practiceLocations": [
{
"address_1": "472 Lincoln St",
"address_purpose": "LOCATION",
"city": "Worcester",
"state": "MA",
"postal_code": "016051917",
"country_code": "US",
"telephone_number": "508-856-7923",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NGUYEN",
"first_name": "KEVIN",
"middle_name": "VAN",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-09",
"last_updated": "2023-01-05",
"certification_date": "2023-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH240526",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.