Active NPI
Julie K Pham, NP
- Adult Health Nurse Practitioner
- Springfield, MO
National Provider Identifier
1376877381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 2020024188
- Practice address
- 2115 S Fremont Ave Ste 3300
Springfield, MO 65804-2246 - Phone
- (417) 820-5200
- Fax
- (214) 820-0993
- NPI assigned
- Sep 23, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 732590 | TX | |
| Adult Health Nurse Practitioner | 363LA2200X | 2020024188 | MO | Primary |
Addresses
Primary practice location
2115 S Fremont Ave Ste 3300
Springfield, MO 65804-2246
Mailing address
2115 S Fremont Ave Ste 3300
Springfield, MO 65804-2246
Phone (417) 820-5200
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 206467703 | Medicaid | TX | |
| 206467704 | Medicaid | TX | |
| 206467702 | Medicaid | TX | |
| 206467705 | Medicaid | TX | |
| 206467701 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211020002972 | MO | Practitioner - Nurse Practitioner | 3779620695 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- University of Texas Medical School at Houston, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Mercy Clinic Springfield Communities
Practice addresses (Care Compare)
2115 S Fremont Ave
3300 MC Gastroenterology Whiteside
Springfield, MO 65804-2246
Phone (417) 820-5200
448 State Hwy 248
Suite 160
Branson, MO 65616-3725
Phone (417) 213-4696
Hospital & facility affiliations
- Mercy Hospital Springfield
- Mercy Hospital Lebanon
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020024188 | MO | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Citywide I D Associates, Inc | Past | Accepting new patients | |
| Physicians and Allied Health Professionals Group, PA | Past | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Locations
448 State Highway 248
Ste 160
Branson, MO 65616
Phone (417) 213-4696
1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379
2115 S Fremont Ave
Ste 3300
Springfield, MO 65804
Phone (417) 820-5200
1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115
2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905
Organizations & group practices 6
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.
-
- Rural Health Clinic/Center
- Willow Springs, MO
- NPI 1972771657
MO
-
- Family Medicine Physician
- Hollister, MO
- NPI 1053350454
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
-
- Specialist
- Addison, TX
- NPI 1982906244
-
- Family Medicine Physician
- Dallas, TX
- NPI 1528011814
Hospital & facility affiliations 11
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": "1253664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634601600000",
"number": "1376877381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2115 S FREMONT AVE STE 3300",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658042246",
"telephone_number": "417-820-5200",
"fax_number": "214-820-0993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2115 S FREMONT AVE STE 3300",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658042246",
"telephone_number": "417-820-5200",
"fax_number": "214-820-0993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "JULIE",
"middle_name": "K",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-23",
"last_updated": "2021-10-19",
"certification_date": "2021-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "TX",
"license": "732590",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MO",
"license": "2020024188",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "206467703",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "206467704",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "206467702",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "206467705",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "206467701",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.