Charlotte Pham, D.O.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

63665 Issued in CT

Practice address

508 Fulton St
Durham, NC 27705-3875

Phone

(919) 286-0411

NPI assigned

May 29, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Valley Physician Enterprise, Inc

  • Surgery Physician
  • Winchester, VA
  • NPI 1538316203

  Physical Medicine & Rehabilitation

  Medicare reassignment NPD
• Winchester Medical Center

  dba Valley Intensivists

  • Critical Care Medicine (Internal Medicine) Physician
  • Winchester, VA
  • NPI 1679711261
  Medicare reassignment NPD
• Valley Physician Enterprise, Inc.

  dba Valley Health Fertility

  • Obstetrics & Gynecology Physician
  • Winchester, VA
  • NPI 1255222535
  NPD
• Winchester Medical Center

  dba Valley Health Pediatrics Department of Winchester Medical Center

  • Pediatrics Physician
  • Winchester, VA
  • NPI 1013874742
  NPD
• Winchester Medical Center

  • Obstetrics & Gynecology Physician
  • Winchester, VA
  • NPI 1760433791
  NPD

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

{
    "created_epoch": "1432857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1255710745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 WHITE PINE DRIVE",
            "city": "DURHAM",
            "state": "NY",
            "postal_code": "244052896",
            "telephone_number": "917-853-5977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 FULTON ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053875",
            "telephone_number": "919-286-0411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4266 Phlox Pl Apt F5",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113552141",
            "country_code": "US",
            "telephone_number": "917-853-5977",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Grand St",
            "address_purpose": "LOCATION",
            "city": "New Britain",
            "state": "CT",
            "postal_code": "060522016",
            "country_code": "US",
            "telephone_number": "917-853-5977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "CHARLOTTE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-29",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0102206601",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CT",
            "license": "63665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "endpointDescription": "N/A",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "North Carolina",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "North Carolina",
            "address_1": "508 Fulton St",
            "city": "Durham",
            "state": "NC",
            "country_code": "US",
            "postal_code": "277053875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Benjamin Martin Petty, M.D.
• Jonathan Eric Petty
• Sarah Peveler, NCSP, LPA
• Bruce T. Peyser, M.D.
• Briana Elise Pfeuffer
• Theresa Xuan Pham, MD
• Cathy Phan
• Nhu-Y Tan Phan, MD
• Phases of Life
• Barbara Lucille Frizzell Phebus

• Physical Medicine & Rehabilitation Physician in Durham, NC
• Providers in Durham, NC by specialty
• Physical Medicine & Rehabilitation Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; 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.

Verify at the official NPI Registry.