Individual provider Active NPI

Khanh PT Nguyen, OTR

  • Occupational Therapist
  • El Paso, TX
National Provider Identifier
1912595869
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
120924 Issued in TX
Practice address
2150 Trawood Dr Ste A100
El Paso, TX 79935-3383
Phone
(915) 333-0200
Fax
(915) 792-0576
NPI assigned
Jan 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 120924 TX Primary

Addresses

Primary practice location

2150 Trawood Dr Ste A100
El Paso, TX 79935-3383

Mailing address

2150 Trawood Dr Ste A100
El Paso, TX 79935-3383
Phone (915) 333-0200

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Clinicsource.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231026000117 TX Practitioner - Occupational Therapist in Private Practice 4688020795 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Little Warriors OT LLC Occupational Therapist CurrentSince Oct 16, 2023 Accepting new patients

Locations

612 N Resler Dr
Ste C
El Paso, TX 79912
Phone (915) 313-4498

6955 N Mesa St
Ste 105
El Paso, TX 79912
Phone (915) 226-0369

4849 N Mesa St
Ste 201
El Paso, TX 79912

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": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1912595869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 TRAWOOD DR STE A100",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799353383",
            "telephone_number": "915-333-0200",
            "fax_number": "915-792-0576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 TRAWOOD DR STE A100",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799353383",
            "telephone_number": "915-333-0200",
            "fax_number": "915-792-0576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KHANH",
        "middle_name": "PT",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-06",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "120924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Clinicsource.com",
            "affiliation": "N",
            "address_1": "2150 Trawood Dr Ste A100",
            "city": "El Paso",
            "state": "TX",
            "country_code": "US",
            "postal_code": "799353383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; 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.