Individual provider Active NPI

Antt Tu Nguyen, C-NP

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1972048742
Registry record updated Jan 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0071909 Issued in OK
Practice address
2636 SW 28TH.
Oklahoma City, OK 73108-5823
Phone
(405) 602-5330
Fax
(405) 835-3932
NPI assigned
Jan 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R0071909 OK Primary

Addresses

Primary practice location

2636 SW 28TH.
Oklahoma City, OK 73108-5823

Mailing address

2636 SW 28TH St
Oklahoma City, OK 73108-5823
Phone (405) 602-5330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170426000177 OK Practitioner - Nurse Practitioner 8628355856 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R0071909OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Affordable Health Services PLLC CurrentSince Apr 1, 2017 Accepting new patients

Locations

2636 SW 28th St
Oklahoma City, OK 73108
Phone (405) 602-5330

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": "1483401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1972048742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2636 SW 28TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731085823",
            "telephone_number": "405-602-5330",
            "fax_number": "405-835-3982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2636 SW 28TH.",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731085823",
            "telephone_number": "405-602-5330",
            "fax_number": "405-835-3932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANTT",
        "middle_name": "TU",
        "name_prefix": "Mrs.",
        "credential": "C-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-03",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0071909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.