Phat P Pham, MD

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

MD00046508 Issued in WA

Practice address

112 Columbia Point Dr Ste 103
Richland, WA 99352-4390

Phone

(509) 747-6707

NPI assigned

Jun 22, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ppham1@direct.psu.edu

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.

• STC Pediatrics LLC

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Philadelphia, PA
  • NPI 1144864547
  NPD
• Providence Health & Services - Washington

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Hoquiam, WA
  • NPI 1043374119
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1194761312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "509-747-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 COLUMBIA POINT DR STE 103",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524390",
            "telephone_number": "509-747-6707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 University Dr",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "800-243-1455",
            "fax_number": "717-531-0401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 Monument Rd Ste 160",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174035057",
            "country_code": "US",
            "telephone_number": "800-243-1455",
            "fax_number": "717-531-0401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2494 Bernville Rd",
            "address_purpose": "LOCATION",
            "city": "Reading",
            "state": "PA",
            "postal_code": "196059469",
            "country_code": "US",
            "telephone_number": "800-243-1455",
            "fax_number": "717-531-0401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2221 Noll Dr",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176037614",
            "country_code": "US",
            "telephone_number": "800-243-1455",
            "fax_number": "717-531-0401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "121 N Nyes Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171123248",
            "country_code": "US",
            "telephone_number": "800-243-1455",
            "fax_number": "717-531-0401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "PHAT",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00046505",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MD",
            "license": "D72813",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "PA",
            "license": "MD461166",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "WA",
            "license": "MD00046508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ppham1@direct.psu.edu",
            "affiliation": "N",
            "address_1": "500 University Dr",
            "city": "Hershey",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170332360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pamela Peterson, RN
• Peggy Ann Peterson, MA
• Susan Lynne Peterson, R.N.
• Katherine Pettijohn, LMHCA
• Bradley James Petty, MD
• Thienan Nguyen Pham, PHARMD
• Amanda Pharris
• Nicole Pheifer, SLP
• David James Pheysey, M.D.
• Lucas N. Phi, DO

• Pediatric Cardiology Physician in Richland, WA
• Providers in Richland, WA by specialty
• Pediatric Cardiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.