Active NPI
Tam Phu
- Pediatric Nurse Practitioner
- St Petersburg, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- ARNP9295757
- Practice address
- 601 5TH St S
St Petersburg, FL 33701-4804 - Phone
- (727) 767-8181
- Fax
- (727) 767-8030
- NPI assigned
- Jan 30, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 9295757 | FL | |
| Pediatric Nurse Practitioner | 363LP0200X | ARNP9295757 | FL | Primary |
Addresses
Primary practice location
601 5TH St S
St Petersburg, FL 33701-4804
Mailing address
601 5TH St S
St Petersburg, FL 33701-4804
Phone (727) 767-8181
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669895405 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1600 SW Archer
Gainesville, FL 32610-3003
1600 SW Archer Rd
Gainesville, FL 32610-3003
1600 SW Archer Rd RM
1191 Uf Health Surgical Specialists Shands
Gainesville, FL 32610-3003
Phone (352) 265-0535
2000 SW Archer Rd
Uf Health Congenital Heart Center Medical P
Gainesville, FL 32610-3003
Phone (352) 265-8250
2001 SW 13TH St
Gainesville, FL 32608-1532
Phone (352) 265-8990
Uf Health Test Site Pop Up 1600 SW Ar
Gainesville, FL 32610-3003
Phone (352) 392-1161
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9295757 | FL | MD | Pediatric Nurse Practitioner |
| ARNP9295757 | FL | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Clinical Practice Association Inc | Current | Accepting new patients | |
| Florida Clinical Practice Association Inc | Current | Accepting new patients |
Locations
1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077
2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990
1549 Gale Lemerand Dr
Gainesville, FL 32610
Phone (352) 265-0496
Interoperability endpoints
- tphu14518@direct.shands.ufl.edu
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.
-
- Surgery Physician
- Gainesville, FL
- NPI 1063463768
-
- Durable Medical Equipment & Medical Supplies
- Ocala, FL
- NPI 1609529478
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455408000000",
"number": "1669895405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 5TH ST S",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337014804",
"telephone_number": "727-767-8181",
"fax_number": "727-767-8030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 5TH ST S",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337014804",
"telephone_number": "727-767-8181",
"fax_number": "727-767-8030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHU",
"first_name": "TAM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-30",
"last_updated": "2016-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "FL",
"license": "9295757",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "FL",
"license": "ARNP9295757",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1669895405",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2016; 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.