Active NPI
Andy An Pham
- Athletic Trainer
- Lincoln, NE
National Provider Identifier
1649965856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 830 Stadium Drive
Lincoln, NE 68588 - Phone
- (402) 472-4224
- NPI assigned
- Apr 5, 2023
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
830 Stadium Drive
Lincoln, NE 68588
Mailing address
363 W Charleston St Apt 514
Lincoln, NE 68528-1467
Phone (916) 716-2461
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680652800000",
"number": "1649965856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "363 W CHARLESTON ST APT 514",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685281467",
"telephone_number": "916-716-2461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 STADIUM DRIVE",
"city": "LINCOLN",
"state": "NE",
"postal_code": "68588",
"telephone_number": "402-472-4224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "ANDY",
"middle_name": "AN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-05",
"last_updated": "2023-04-05",
"certification_date": "2023-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.