Individual provider Active NPI

Megan Wren Pham, CNM

  • Advanced Practice Midwife
  • Fredericksburg, VA
National Provider Identifier
1205608122
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
0024188548 Issued in VA
Practice address
1101 Sam Perry Blvd Ste 401
Fredericksburg, VA 22401-4466
Phone
(540) 940-2000
Fax
(540) 940-2001
NPI assigned
Oct 24, 2023
Last updated
Oct 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 0024188548 VA Primary

Addresses

Primary practice location

1101 Sam Perry Blvd Ste 401
Fredericksburg, VA 22401-4466

Mailing address

9805 Danford St
Fredericksburg, VA 22407-8369
Phone (540) 907-9017

Other practice location 1

9755 Courthouse Rd Ste 104
Spotsylvania, VA 22553-1984
Phone (540) 940-2000

Other practice location 2

1001 Sam Perry Blvd
Fredericksburg, VA 22401-4453
Phone (540) 741-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231130004059 VA Practitioner - Certified Nurse Midwife (CNM) 6305294372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4710 Spotsylvania Pkwy
Suite 206
Fredericksburg, VA 22407-9433
Phone (540) 940-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Healthcare Physicians CurrentSince Jul 15, 2024 Accepting new patients
Mary Washington Healthcare Physicians CurrentSince Jul 15, 2024 Accepting new patients
Elite Gynecology and Wellness LLC PastSince Nov 15, 2023 Accepting new patients

Locations

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

1101 Sam Perry Blvd
Ste 401
Fredericksburg, VA 22401
Phone (540) 899-5864

4710 Spotsylvania Pkwy
Ste 206
Fredericksburg, VA 22407
Phone (540) 741-0460

9755 Courthouse Rd
Ste 104
Spotsylvania, VA 22553
Phone (540) 374-7020

Interoperability endpoints

  • Direct secure messaging: megan.pham.1@21079.direct.athenahealth.com
  • Direct secure messaging: mpham54828@marywashingtonhealthcare.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1205608122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9805 DANFORD ST",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224078369",
            "telephone_number": "540-907-9017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 SAM PERRY BLVD STE 401",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014466",
            "telephone_number": "540-940-2000",
            "fax_number": "540-940-2001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9755 Courthouse Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Spotsylvania",
            "state": "VA",
            "postal_code": "225531984",
            "country_code": "US",
            "telephone_number": "540-940-2000",
            "fax_number": "540-940-2001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 Sam Perry Blvd",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224014453",
            "country_code": "US",
            "telephone_number": "540-741-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "MEGAN",
        "middle_name": "WREN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "VA",
            "license": "0024188548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.