Active NPI
Kieu Thi Tran, SA-C
- Surgical Technologist
- Frankfort, IL
National Provider Identifier
1912241779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Technologist
- License
- 09-255
- Practice address
- 21200 S la Grange Rd Ste 322
Frankfort, IL 60423-2003 - Phone
- (815) 933-3955
- Fax
- (815) 464-2614
- NPI assigned
- Nov 19, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Technologist | 246ZS0410X | 09-255 | CO | Primary |
Addresses
Primary practice location
21200 S la Grange Rd Ste 322
Frankfort, IL 60423-2003
Mailing address
21200 S la Grange Rd
Frankfort, IL 60423-2003
Phone (815) 933-3955
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09-255 | CO | MD | Surgical Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366761600000",
"number": "1912241779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21200 S LA GRANGE RD",
"city": "FRANKFORT",
"state": "IL",
"postal_code": "604232003",
"telephone_number": "815-933-3955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21200 S LA GRANGE RD STE 322",
"city": "FRANKFORT",
"state": "IL",
"postal_code": "604232003",
"telephone_number": "815-933-3955",
"fax_number": "815-464-2614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAN",
"first_name": "KIEU",
"middle_name": "THI",
"credential": "SA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-19",
"last_updated": "2013-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "CO",
"license": "09-255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.