NPIMap

Individual provider Active NPI

Kieuhan Theresa Pham, PA-C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1497093256
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
APA2216 Issued in OK
Practice address
3330 NW 56TH St Ste 208
Oklahoma City, OK 73112-4426
Phone
(405) 604-0688
Fax
(405) 604-0689
NPI assigned
Jan 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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 APA2216 OK Primary

Addresses

Primary practice location

3330 NW 56TH St Ste 208
Oklahoma City, OK 73112-4426

Mailing address

3366 NW Expressway
Suite 400
Oklahoma City, OK 73112-4462
Phone (405) 702-1310

Other names 1

  • Ms. Kieuhan Theresa Tran Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140827002641 OK Practitioner - Physician Assistant 8628296985 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2216OKMDChiropractor
APA2216OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kpham59508@direct.integrisok.com
  • Direct secure messaging: tpham@okddsi.gwaydirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 10

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

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Digestive Disease Specialists Inc 18 clinicians

Practice addresses (Care Compare)

10029 N Oklahoma Ave
Suite 200
Oklahoma City, OK 73114-7454
Phone (405) 702-1300

Hospital & facility affiliations

  • Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028
  • Integris Canadian Valley Hospital Hospital, Yukon, OK, CCN 370211
  • Integris Health Edmond Hospital Hospital, Edmond, OK, CCN 370236
  • Integris Southwest Medical Center Hospital, Oklahoma City, OK, CCN 370106
  • Integris Health Enid Hospital Hospital, Enid, OK, CCN 370016

NPI Registry JSON

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

{
    "created_epoch": "1359417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1497093256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3366 NW EXPRESSWAY",
            "address_2": "SUITE 400",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124462",
            "telephone_number": "405-702-1310",
            "fax_number": "405-702-1281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 NW 56TH ST STE 208",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124426",
            "telephone_number": "405-604-0688",
            "fax_number": "405-604-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "KIEUHAN",
        "middle_name": "THERESA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-29",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "APA2216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIEUHAN",
            "last_name": "TRAN",
            "middle_name": "THERESA",
            "prefix": "MS.",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.