Individual provider Active NPI

Nhung S Pham, MD

  • Internal Medicine Physician
  • Columbus, OH
National Provider Identifier
1417903352
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.071379 Issued in OH
Practice address
4885 Olentangy River Rd Ste 1-20
Columbus, OH 43214-1953
Phone
(614) 268-6555
Fax
(614) 457-5723
NPI assigned
May 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35.071379 OH
Internal Medicine Physician 207R00000X 35.071379 OH Primary

Addresses

Primary practice location

4885 Olentangy River Rd Ste 1-20
Columbus, OH 43214-1953

Mailing address

4885 Olentangy River Rd Ste 1-20
Columbus, OH 43214-1953
Phone (614) 268-6555

Other identifiers 1

IdentifierTypeStateIssuer
2164161MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050329001297 OH Practitioner - Emergency MedicinePractitioner - Internal MedicinePractitioner - Hospitalist 8022064351 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.071379OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians Inc Current Accepting new patients
Osu Emergency Medicine LLC CurrentSince Aug 6, 2014 Accepting new patients
Central Ohio Primary Care Physicians, Inc. Internal Medicine CurrentSince Sep 6, 2022 Accepting new patients
Central Ohio Primary Care Physicians, Inc. CurrentSince Sep 6, 2022 Accepting new patients
Licking Memorial Professional Corp. Past Accepting new patients
Access Urgent Medical Care of Upper Arlington Inc Past Accepting new patients
Mount Carmel Health Past Accepting new patients
Holzer Clinic, LLC Past Accepting new patients
West Chester Hospital LLC Internal Medicine Past Accepting new patients
University of Cincinnati Medical Center, LLC Past Accepting new patients

Locations

4885 Olentangy River Rd
Columbus, OH 43214
Phone (614) 326-5665

4885 Olentangy River Rd
Ste 1-20
Columbus, OH 43214
Phone (614) 268-6555

3525 Olentangy River Rd
Ste 4330
Columbus, OH 43214
Phone (614) 255-6930

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

Interoperability endpoints

  • Direct secure messaging: spham19076@copcp.medicity.net

Organizations & group practices 10

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1417903352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4885 OLENTANGY RIVER RD STE 1-20",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432141953",
            "telephone_number": "614-268-6555",
            "fax_number": "614-457-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4885 OLENTANGY RIVER RD STE 1-20",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432141953",
            "telephone_number": "614-268-6555",
            "fax_number": "614-457-5723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "NHUNG",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.071379",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.071379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2164161",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.