Individual provider Active NPI

Perrine Pham, AU.D

  • Audiologist
  • Oklahoma City, OK
National Provider Identifier
1740694710
Registry record updated Oct 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
147001474 Issued in IL
Practice address
3434 NW 56TH St
Suite 101
Oklahoma City, OK 73112-4488
Phone
(630) 232-9153
NPI assigned
Jun 17, 2014
Last updated
Oct 20, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 147001474 IL Primary

Addresses

Primary practice location

3434 NW 56TH St
Suite 101
Oklahoma City, OK 73112-4488

Mailing address

637 W State St
Geneva, IL 60134-2159
Phone (630) 618-2519

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170313001739 OK Practitioner - Qualified Audiologist 0547488025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

2017 W I 35 Frontage Rd
Mercy Clinic
Edmond, OK 73013-8504
Phone (405) 757-3365

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4622OKMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oklahoma Communities CurrentSince Dec 18, 2023 Accepting new patients
Hearing Care Clinic of Downers Grove PC Audiologist CurrentSince Aug 25, 2024 Accepting new patients

Locations

637 W State St
Geneva, IL 60134
Phone (630) 232-9153

2017 W I 35 Frontage Rd
Edmond, OK 73013
Phone (405) 509-2800

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

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

NPI Registry JSON

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1740694710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 W STATE ST",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342159",
            "telephone_number": "630-618-2519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 NW 56TH ST",
            "address_2": "SUITE 101",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124488",
            "telephone_number": "630-232-9153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "PERRINE",
        "credential": "AU.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147001474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.