Sopheak Nguon, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

4351051887 Issued in MI

Practice address

1458 W Center Rd Ste 1
Essexville, MI 48732-2151

Phone

(989) 895-4625

Fax

(989) 895-4696

NPI assigned

Jun 21, 2023

Last updated

Jun 21, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• McLaren Bay Region

  • Psychiatry Physician
  • Bay City, MI
  • NPI 1942560339
  NPD (past)

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

{
    "created_epoch": "1687305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1932884301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1458 W CENTER RD STE 1",
            "city": "ESSEXVILLE",
            "state": "MI",
            "postal_code": "487322151",
            "telephone_number": "989-895-4625",
            "fax_number": "989-895-4696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1458 W CENTER RD STE 1",
            "city": "ESSEXVILLE",
            "state": "MI",
            "postal_code": "487322151",
            "telephone_number": "989-895-4625",
            "fax_number": "989-895-4696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUON",
        "first_name": "SOPHEAK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-21",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351051887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Robert Mularz
• Mark Murphy, RPH
• Pamela Ann Nadzan, LPC
• Deanna S. Nesbitt, OTR/L
• Neurocare Home Health, LLC
• Brenda Niemiec, O.T.R.L.
• Audrey Faith Michelle Ownsby, MS, BCBA
• James Pail, PAC
• Swetha Parimi
• Jason Lee Paris, BSW, DP-C

• Student in an Organized Health Care Education/Training Program in Essexville, MI
• Providers in Essexville, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.