Active NPI
Liem Pham
- Student in an Organized Health Care Education/Training Program
- Burlington, VT
National Provider Identifier
1164225025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 111 Colchester Ave
Burlington, VT 05401-1473 - Phone
- (802) 847-0000
- NPI assigned
- Mar 28, 2025
- Last updated
- Mar 28, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | Primary |
Addresses
Primary practice location
111 Colchester Ave
Burlington, VT 05401-1473
Mailing address
58 William Barton Dr
Tiverton, RI 02878-3894
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250709003547 | VT | Order and Referring Only - General Surgery | 8628582764 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743120000000",
"number": "1164225025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "58 WILLIAM BARTON DR",
"city": "TIVERTON",
"state": "RI",
"postal_code": "028783894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 COLCHESTER AVE",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054011473",
"telephone_number": "802-847-0000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "LIEM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-03-28",
"last_updated": "2025-03-28",
"certification_date": "2025-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.