Jeannie Pham, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

D67481 Issued in MD

Practice address

604 Solarex CT Unit 201
Frederick, MD 21703-8655

Phone

(301) 663-8263

Fax

(301) 682-5326

NPI assigned

Aug 27, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

PsychiatryAlso: Pediatric Medicine

Education

Louisiana State University School of Medicine in Shreveport, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mosaic Community Services, IncGroup PAC ID 0941289417, 63 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Mosaic Community Services, Inc.

  • Adult Mental Health Clinic/Center
  • Timonium, MD
  • NPI 1265539142
  Medicare reassignment Care Compare group NPD
• Family Services, Inc

  • Child & Adolescent Psychiatry Physician
  • Gaithersburg, MD
  • NPI 1780641928

  DC

  Medicare reassignment NPD
• Way Station, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hagerstown, MD
  • NPI 1124490784
  Medicare reassignment
• Family Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gaithersburg, MD
  • NPI 1881218816
  NPD
• Mosaic Community Services, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Gaithersburg, MD
  • NPI 1710466313
  NPD
• Mosaic Community Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Frederick, MD
  • NPI 1295489250
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1720271430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 SOLAREX CT UNIT 201",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217038655",
            "telephone_number": "301-663-8263",
            "fax_number": "301-682-5326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 SOLAREX CT UNIT 201",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217038655",
            "telephone_number": "301-663-8263",
            "fax_number": "301-682-5326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "JEANNIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-27",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D67481",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": "D67481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nico Petretta
• Heather Marie Petro, LCPC
• Elizabeth Jean Petrolle, LCSW-C
• Alberta Jane Peugeot, ARNP-C
• Leah Pfister
• Karen Pheasant, DO
• Debra Sue Phebus
• Amanda G Phelan, LCSW-C
• Melanie Joanna Phelan
• Jayme Micaela Driver Phelps, APRN

• Child & Adolescent Psychiatry Physician in Frederick, MD
• Providers in Frederick, MD by specialty
• Child & Adolescent Psychiatry Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; 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.

Verify at the official NPI Registry.