Individual provider Active NPI

Oanh Ngoc Phung, PA-C

  • Physician Assistant
  • Erwin, NC
National Provider Identifier
1306479654
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-09797 Issued in NC
Practice address
901 Denim Dr
Erwin, NC 28339-2307
Phone
(910) 897-5521
NPI assigned
Feb 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-09797 NC Primary

Addresses

Primary practice location

901 Denim Dr
Erwin, NC 28339-2307

Mailing address

3708 Forestview Rd Ste 207
Raleigh, NC 27612-2391
Phone (919) 781-8781

Other practice location 1

6602 Knightdale Blvd Ste 102
Knightdale, NC 27545-6526
Phone (919) 747-5210

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ophung1011202@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20200527000662 NC Practitioner - Physician Assistant 5395166557 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians
Unc Physicians Network LLCGroup PAC ID 5496940546, 985 clinicians

Practice addresses (Care Compare)

11200 Governor Manly Way
Raleigh, NC 27614-7360

1165 US Hwy 70 W
Garner, NC 27529-2547
Phone (984) 960-1400

3050 Duraleigh Rd
Raleigh, NC 27612-5451

34 Healthpark Way
Clayton, NC 27520-4497
Phone (919) 585-8850

37 Pineville Blvd
Clayton, NC 27527-9355

4420 Lake Boone TRL
Raleigh, NC 27607-7505

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514-2601
Phone (919) 942-5123

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Unc Physicians Network LLC CurrentSince Feb 24, 2024 Accepting new patients
Unc Physicians Network LLC CurrentSince Feb 24, 2024 Accepting new patients
Wake Specialty Physicians LLC CurrentSince Apr 11, 2022 Accepting new patients
Wake Specialty Physicians LLC CurrentSince Apr 11, 2022 Accepting new patients
Rex Hospital Inc Past Accepting new patients

Locations

6013 Farrington Rd
Ste 101
Chapel Hill, NC 27517
Phone (919) 957-6610

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

2934 N Elm St
Ste B
Lumberton, NC 28358
Phone (910) 272-1175

6701B NC Highway 135
Mayodan, NC 27027
Phone (336) 635-6816

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

10000 Falls of Neuse Rd
Ste 205
Raleigh, NC 27614
Phone (919) 350-1630

Interoperability endpoints

  • Direct secure messaging: lphung28445@directhisp.wakemed.org
  • Direct secure messaging: ophung1011202@direct.unc.nchie.net

Organizations & group practices 9

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1581638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1306479654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3708 FORESTVIEW RD STE 207",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276122391",
            "telephone_number": "919-781-8781",
            "fax_number": "919-781-8782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 DENIM DR",
            "city": "ERWIN",
            "state": "NC",
            "postal_code": "283392307",
            "telephone_number": "910-897-5521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6602 Knightdale Blvd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Knightdale",
            "state": "NC",
            "postal_code": "275456526",
            "country_code": "US",
            "telephone_number": "919-747-5210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHUNG",
        "first_name": "OANH",
        "middle_name": "NGOC",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-14",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ophung1011202@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "6602 Knightdale Blvd Ste 102",
            "city": "Knightdale",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275456526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Erwin, NC

Sources for this page

Verify at the official NPI Registry.