Thao H Pham, M.D.

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

License

37275 Issued in KY

Practice address

914 N Dixie Ave
Suite 100
Elizabethtown, KY 42701-2520

Phone

(270) 765-6149

Fax

(270) 737-5235

NPI assigned

Aug 9, 2005

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Spero Health of Kentucky, LLC

  • Addiction Medicine (Family Medicine) Physician
  • Danville, KY
  • NPI 1982102109
  NPD

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1336140698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 N DIXIE AVE",
            "address_2": "SUITE 100",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012520",
            "telephone_number": "270-765-6149",
            "fax_number": "270-737-5235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 N DIXIE AVE",
            "address_2": "SUITE 100",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012520",
            "telephone_number": "270-765-6149",
            "fax_number": "270-737-5235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "THAO",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "KY",
            "license": "37275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2649647000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH PLAN",
            "identifier": "50001581",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000301574",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64062102",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Lee Perdue
• Tara Perdue, PA
• Angela Carol Peters
• Vanessa Peters, LCSW
• Christine K. Pham, MD
• Dennis Michael Phegley
• Physical Therapy Associates, Inc
• Physical Therapy Pros LLC (Physical Therapy Way LLC)
• Keslie Dawn Pickett, APSS
• Lawerence E Pickett, APSS

• Allergy Physician in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Allergy Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.