Phong Los, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2100 Gardiner LN
Louisville, KY 40205-2962

Phone

(502) 413-8640

NPI assigned

Jul 22, 2026

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

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

{
    "created_epoch": "1784678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1114848728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 ABBEY LN",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488589137",
            "telephone_number": "989-289-7977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 GARDINER LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402052962",
            "telephone_number": "502-413-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOS",
        "first_name": "PHONG",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-22",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Louise Lorence, LCSW
• Jose Torio Lorenzo, M.D.
• Ann Elizabeth Lorimer, PA-C
• Lora Lorincz
• Lorri Livers Houck, PLLC
• Ashley Nichole Losch, APRN
• Michelle Rhea Lose, APRN, PMHNP-BC
• Regina Losik Amarante
• Emily Losik, MS, CCC-SLP
• Ashley Loss

• Physician Assistant in Louisville, KY
• Providers in Louisville, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.