Kim Oanh Pham, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA 26602 Issued in FL

Practice address

3248 Lithia Pinecrest Rd Ste 102
Valrico, FL 33596-5682

Phone

(813) 622-1366

NPI assigned

Apr 19, 2016

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Cora Health

  • Rehabilitation Clinic/Center
  • Lutz, FL
  • NPI 1821444241
  NPD (past)

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461024000000",
    "number": "1114371887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16103 STAGS LEAP DR",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335592003",
            "telephone_number": "813-325-9562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3248 LITHIA PINECREST RD STE 102",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335965682",
            "telephone_number": "813-622-1366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "KIM",
        "middle_name": "OANH",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-19",
        "last_updated": "2016-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 26602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen Yvonne Peterkin-Byrd, RN
• Elizabeth Ann Petro, RN
• Jacob Matthew Petro
• James Michael Petro, O.D.
• Sara Michele Pfeifer
• Tony Nguyen Pham, O.D.
• Jan Denice Phelps, ARNP
• Cheryl Marie Phillips, APN
• Jessica O'Keefe Pierce, OD
• Play Together Speech Therapy LLC

• Physical Therapy Assistant in Valrico, FL
• Providers in Valrico, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; 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.