Tri Dai Pham

Primary specialty

PharmacistTaxonomy code 183500000X

License

0202208632 Issued in VA

Practice address

620 John Paul Jones Cir
Portsmouth, VA 23708-2111

Phone

(757) 953-5000

NPI assigned

Oct 17, 2024

Last updated

Oct 17, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1154142602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11401 BRAIDSTONE LN",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238385000",
            "telephone_number": "804-536-8967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 JOHN PAUL JONES CIR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237082111",
            "telephone_number": "757-953-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "TRI",
        "middle_name": "DAI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-17",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202208632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrienne Dawn Pettebone, D.O.
• Darlene Petway
• Phaith Home Healthcare
• Tonga Lynn Pham
• Trang Pham, PHARMD
• Clarence David Phaup Jr.
• Sohila Mansourzadeh Phelps, RN
• Alan Frederick Philippi, D.O.
• Elspeth Laura Phillips, CRNA, DNP
• Tanisha Marie Phillips, RBT

• Pharmacist in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Pharmacist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.