Individual provider Active NPI

Kerry Jo Pham, ARNP, CNM

  • Advanced Practice Midwife
  • Pensacola, FL
National Provider Identifier
1215479506
Registry record updated Feb 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
ARNP9265686 Issued in FL
Practice address
975 Royce St
Pensacola, FL 32503-2463
Phone
(850) 361-7250
Fax
(850) 610-4277
NPI assigned
Nov 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2024

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 ARNP9265686 FL Primary

Addresses

Primary practice location

975 Royce St
Pensacola, FL 32503-2463

Mailing address

975 Royce St
Pensacola, FL 32503-2463
Phone (850) 361-7250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
ARNP9265686FLMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Stand & Deliver Midwifery, LLC CurrentSince Aug 1, 2021 Accepting new patients
Stand & Deliver Midwifery, LLC Advanced Practice Midwife CurrentSince May 1, 2022 Accepting new patients

Locations

975 Royce St
Pensacola, FL 32503
Phone (850) 332-7760

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1479340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707004800000",
    "number": "1215479506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 ROYCE ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032463",
            "telephone_number": "850-361-7250",
            "fax_number": "850-610-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 ROYCE ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032463",
            "telephone_number": "850-361-7250",
            "fax_number": "850-610-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "KERRY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "ARNP, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-17",
        "last_updated": "2024-02-04",
        "certification_date": "2024-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "ARNP9265686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.