Active NPI
Thien-an Thi Pham, PHARM D.
- Pharmacist
- Mount Dora, FL
National Provider Identifier
1558972455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS53816
- Practice address
- 18910 US Highway 441
Mount Dora, FL 32757-6736 - Phone
- (352) 735-0600
- Fax
- (352) 735-4205
- NPI assigned
- Aug 13, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS53816 | FL | Primary |
Addresses
Primary practice location
18910 US Highway 441
Mount Dora, FL 32757-6736
Mailing address
18910 US Highway 441
Mount Dora, FL 32757-6736
Phone (352) 735-0600
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS53816 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New 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": "1597276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597276800000",
"number": "1558972455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18910 US HIGHWAY 441",
"city": "MOUNT DORA",
"state": "FL",
"postal_code": "327576736",
"telephone_number": "352-735-0600",
"fax_number": "352-735-4205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18910 US HIGHWAY 441",
"city": "MOUNT DORA",
"state": "FL",
"postal_code": "327576736",
"telephone_number": "352-735-0600",
"fax_number": "352-735-4205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "THIEN-AN",
"middle_name": "THI",
"name_prefix": "Dr.",
"credential": "PHARM D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-13",
"last_updated": "2020-08-13",
"certification_date": "2020-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS53816",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Dora, FL
- Nicholas Vincent Peracchio, DMD
- Jeanette Marie Perez
- Alexandra Perkinson, LMHC
- Mary T Perozich, M.ED., CCC-SLP
- Kira Peters
- Christopher John Phillips, MD
- Imani Akanne Phillips, BA, RBT
- Gritchalach Phophutthaprasit, AP, DOM
- Physicians Imaging-Mt Dora LLC
- Physicians of Central Florida, LLC (Physicians of Central Florida, PA)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.