Active NPI
Lan Anh Nguyen
- Physical Therapist
- Lady Lake, FL
National Provider Identifier
1992306351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT36185
- Practice address
- 809 County Road 466
C301
Lady Lake, FL 32159 - Phone
- (352) 251-3711
- NPI assigned
- Nov 3, 2020
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT36185 | FL | Primary |
Addresses
Primary practice location
809 County Road 466
C301
Lady Lake, FL 32159
Mailing address
17863 SW 2ND St
Pembroke Pines, FL 33029-3914
Phone (954) 830-4048
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201130000602 | FL | Practitioner - Physical Therapist in Private Practice | 4082025820 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT36185 | FL | MD | Physical Therapist |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604361600000",
"number": "1992306351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17863 SW 2ND ST",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330293914",
"telephone_number": "954-830-4048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "809 COUNTY ROAD 466",
"address_2": "C301",
"city": "LADY LAKE",
"state": "FL",
"postal_code": "32159",
"telephone_number": "352-251-3711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "LAN ANH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-03",
"last_updated": "2020-11-03",
"certification_date": "2020-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT36185",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lady Lake, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.