Individual provider Active NPI

Debbie Nhung Pham, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1215611314
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1125290 Issued in TX
Practice address
7520 N Beach St Ste 108
Fort Worth, TX 76137-1507
Phone
(817) 984-7100
NPI assigned
Jun 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1125290 TX Primary

Addresses

Primary practice location

7520 N Beach St Ste 108
Fort Worth, TX 76137-1507

Mailing address

1512 Lowes Farm Pkwy
Mansfield, TX 76063-8616
Phone (817) 455-3385

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241212000221 TX Practitioner - Nurse Practitioner 1355877499 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1125290TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tarrant Internal Medicine & Pediatrics, PLLC CurrentSince Oct 6, 2024 Accepting new patients

Locations

7520 N Beach St
Ste 108
Ft Worth, TX 76137
Phone (682) 463-0400

Organizations & group practices 1

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": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1215611314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 LOWES FARM PKWY",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638616",
            "telephone_number": "817-455-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7520 N BEACH ST STE 108",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761371507",
            "telephone_number": "817-984-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "DEBBIE",
        "middle_name": "NHUNG",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1125290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.