Theresa Pham

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

601 Martin Luther King Jr Dr
432 FL Atkins Building
Winston-Salem, NC 27110-0001

Phone

(336) 750-3174

NPI assigned

Sep 7, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1599436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599436800000",
    "number": "1043824055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2178 FLYNN DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542935",
            "telephone_number": "978-548-7837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 MARTIN LUTHER KING JR DR",
            "address_2": "432 FL ATKINS BUILDING",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271100001",
            "telephone_number": "336-750-3174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "THERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-07",
        "last_updated": "2020-09-07",
        "certification_date": "2020-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl C Pfruender, PT, DPT, MTC
• Justin Charles Pfruender, DPT
• Alice Phuong Quynh Pham, MD
• Jamie Pham, DO
• Quoc Pham
• Daniel Duong Phan, M.D.
• Thai Phan, MD
• Kathryn Weldon Phares, CRNA
• Nina Douglas Phaup, CRNA
• Anna Rae Phelps, OTR/L

• Occupational Therapist in Winston-Salem, NC
• Providers in Winston-Salem, NC by specialty
• Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.