Thanh Phan, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1057298 Issued in TX

Practice address

3447 Renner Rd Ste 120
Plano, TX 75074-0051

Phone

(469) 384-2989

Fax

(469) 666-8180

NPI assigned

Oct 20, 2021

Sex

Male

Sole proprietor

Yes

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

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• TP Innovation Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Plano, TX
  • NPI 1124808829
  Medicare reassignment NPD Authorized official
• North Star Psychiatry PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Plano, TX
  • NPI 1194179069
  Medicare reassignment NPD
• Pavan Pamadurthi M.D., P.a.

  • Psychiatry Physician
  • Plano, TX
  • NPI 1841689221
  NPD

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1083377568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3447 RENNER RD STE 120",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750740051",
            "telephone_number": "469-384-2989",
            "fax_number": "469-666-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3447 RENNER RD STE 120",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750740051",
            "telephone_number": "469-384-2989",
            "fax_number": "469-666-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "THANH",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-20",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1057298",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1057298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rocio Lisseth Phan Flores, CF-SLP
• Aidan N Phan, DDS, MD
• Amanda Bichvan Phan, DDS
• Emily A Phan, PA-C
• Oanh Phan, PHARM D
• Thuy Lynh Phan, D.O.
• Mary Frances Phares, FNP-C
• Pharmblue LLC
• Bailey Phelan, M.A., SLP
• Jada R Pherribo

• Psychiatric/Mental Health Nurse Practitioner in Plano, TX
• Providers in Plano, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.