Charmiqua Audrelle Pham

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

6608 Issued in MN

Practice address

671 Vandalia St
Saint Paul, MN 55114-1312

Phone

(651) 698-2406

NPI assigned

Nov 11, 2020

Sex

Female

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 MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Planned Parenthood MN, ND, SDGroup PAC ID 6002709631, 27 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Planned Parenthood Minnesota, North Dakota, South Dakota

  • Non-Surgical Family Planning Clinic/Center
  • Saint Paul, MN
  • NPI 1629057146
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1605052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1518569805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "671 VANDALIA ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141312",
            "telephone_number": "651-698-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "671 VANDALIA ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141312",
            "telephone_number": "651-698-2406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "CHARMIQUA",
        "middle_name": "AUDRELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-11",
        "last_updated": "2022-04-28",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "6608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phalen Family Pharmacy LTD
• Phalen Family Pharmacy LTD
• Maly Phaly
• Andrew Pham
• Camelia Pham, DDS
• Dang Hong Pham
• Ignatius Duy-Anh Pham
• Kevin Cuong Pham, OD
• Phuong-Giang Thi Pham, DDS
• Susan H. Pham, DC, DAAPM, DACBN

• Nurse Practitioner in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; 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.

Verify at the official NPI Registry.