Individual provider Active NPI

Thang Pham, PHARM. D

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Cordova, TN
National Provider Identifier
1487053476
Registry record updated Jan 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
38655 Issued in TN
Practice address
676 N Germantown Pkwy
Cordova, TN 38018-6210
Phone
(901) 756-1138
NPI assigned
Aug 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 38655 TN
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X E13657 MS
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PD12877 AR
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 38655 TN Primary

Addresses

Primary practice location

676 N Germantown Pkwy
Cordova, TN 38018-6210

Mailing address

8621 Meadow Vale Dr
Memphis, TN 38125-3483
Phone (901) 857-9491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PD12877ARMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
E13657MSMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
38655TNMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

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": "1408060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578787200000",
    "number": "1487053476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8621 MEADOW VALE DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381253483",
            "telephone_number": "901-857-9491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N GERMANTOWN PKWY",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380186210",
            "telephone_number": "901-756-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "THANG",
        "credential": "PHARM. D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-15",
        "last_updated": "2020-01-12",
        "certification_date": "2020-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "38655",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MS",
            "license": "E13657",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "AR",
            "license": "PD12877",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "TN",
            "license": "38655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2020; 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.