NPIMap

Individual provider Active NPI

John Pham, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Thomasville, GA
National Provider Identifier
1588870570
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
64243 Issued in GA
Practice address
915 Gordon Ave
Thomasville, GA 31792-6614
Phone
(229) 228-2762
NPI assigned
May 15, 2007
Last updated
Jan 4, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 35.092634 OH
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 64243 GA Primary

Addresses

Primary practice location

915 Gordon Ave
Thomasville, GA 31792-6614

Mailing address

130 N Broad St
Thomasville, GA 31792-8132
Phone (229) 228-6496

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20101004000142 GA Practitioner - Pathology 8022200575 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Virginia Commonwealth University, School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Associates, P.C.Group PAC ID 0143214460, 4 clinicians
Pineview PathologyGroup PAC ID 6800268038, 4 clinicians

Practice addresses (Care Compare)

130 N Broad St
Thomasville, GA 31792-8132
Phone (229) 228-6496

2501 N Patterson St
Valdosta, GA 31602-1735
Phone (229) 421-6659

915 Gordon Ave
Thomasville, GA 31792-6614
Phone (229) 228-6496

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.092634OHMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Associates, P.C. CurrentSince Jul 1, 2010 Accepting new patients
Pineview Pathology Anatomic Pathology & Clinical Pathology CurrentSince Nov 1, 2022 Accepting new patients
Physician Laboratory Consultants LLC Past Accepting new patients

Locations

130 N Broad St
Thomasville, GA 31792
Phone (229) 228-6496

915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

5700 Southwyck Blvd
Toledo, OH 43614

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1588870570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 N BROAD ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317928132",
            "telephone_number": "229-228-6496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 GORDON AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926614",
            "telephone_number": "229-228-2762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OH",
            "license": "35.092634",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "GA",
            "license": "64243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

Verify at the official NPI Registry.