Nghia Trong Phan, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT008216 Issued in GA

Practice address

100 N Macon St
Macon, GA 31210-6563

Phone

(478) 200-6970

NPI assigned

Sep 11, 2018

Last updated

Aug 15, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

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  • NPI 1164461190
  Medicare reassignment NPD
• Hughston Clinic, PC

  • Durable Medical Equipment & Medical Supplies
  • Newnan, GA
  • NPI 1902682347
  NPD

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1508349077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "FORTSON",
            "state": "GA",
            "postal_code": "318080370",
            "telephone_number": "706-494-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MACON ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312106563",
            "telephone_number": "478-200-6970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "NGHIA",
        "middle_name": "TRONG",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-11",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christy Renee Peterson, MD
• Michael Gregory Peterson Jr., NP
• Catherine Petterson, D.D.S.
• Chuc V Pham, MD
• Madeline Pham, MD
• Pharmalab,LLC
• Pharmscript of Ga LLC
• Heather E Phelan, CRNA
• Kwanjula A Phelps
• Lazonya Phelps

• Physical Therapist in Macon, GA
• Providers in Macon, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.