Active NPI
Phong T Ly, PHARMD
- Pharmacotherapy Pharmacist
- North Las Vegas, NV
National Provider Identifier
1619640968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- RPH031572
- Practice address
- 6900 N Pecos Rd
North Las Vegas, NV 89086-4400 - Phone
- (626) 322-8444
- NPI assigned
- Jul 30, 2021
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | RPH031572 | GA | Primary |
Addresses
Primary practice location
6900 N Pecos Rd
North Las Vegas, NV 89086-4400
Mailing address
3150 W Twain Ave Apt 210
Las Vegas, NV 89103-1920
Phone (626) 322-8444
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 |
|---|---|---|---|
| RPH031572 | GA | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638316800000",
"number": "1619640968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3150 W TWAIN AVE APT 210",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891031920",
"telephone_number": "626-322-8444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6900 N PECOS RD",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890864400",
"telephone_number": "626-322-8444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LY",
"first_name": "PHONG",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-30",
"last_updated": "2021-12-01",
"certification_date": "2021-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "GA",
"license": "RPH031572",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.