Amy Pham, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

3535 S Market St Ste 900
West Valley City, UT 84119-3651

Phone

(385) 430-1430

NPI assigned

Nov 8, 2022

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)

Enrolled

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.

• Metrodora ASC, LLC

  dba Metrodora CAI

  • Ambulatory Surgical Clinic/Center
  • West Valley City, UT
  • NPI 1043955602
  NPD

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1164130258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 E WILMINGTON AVE UNIT A202",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841061001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 S MARKET ST STE 900",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841193651",
            "telephone_number": "385-430-1430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5121 S Cottonwood St",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "UT",
            "postal_code": "841075701",
            "country_code": "US",
            "telephone_number": "801-507-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "AMY",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-08",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blake Peterson, DC
• Bradley R Peterson, DC
• Katelyn Peterson
• Kelsey Lin Peterson
• Sean Darrell Peterson, MD
• Huong T Pham
• Tu Phan, RPH
• Pharmacare, LLC
• Pharmacare, LLC (Reeva Pharmacy)
• Pharmacare, LLC (Oquirrh Mountain Pharmacy West Valley)

• Registered Dietitian in West Valley City, UT
• Providers in West Valley City, UT by specialty
• Registered Dietitian in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; 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.