NPIMap

Individual provider Active NPI

Kristi A Pham

  • Family Nurse Practitioner
  • Newport News, VA
National Provider Identifier
1740955343
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024181251 Issued in VA
Practice address
11842 Rock Landing Dr Ste 100
Newport News, VA 23606-4437
Phone
(757) 873-0338
NPI assigned
Aug 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024181251 VA Primary

Addresses

Primary practice location

11842 Rock Landing Dr Ste 100
Newport News, VA 23606-4437

Mailing address

7217 Jeanne Dr
Gloucester, VA 23061-4355
Phone (757) 634-6118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250827000080 VA Practitioner - Nurse Practitioner 6103326772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidewater Physicians Multispecialty Group, PCGroup PAC ID 2860398526, 259 clinicians

Practice addresses (Care Compare)

1030 Champions Way
Suffolk, VA 23435-3914
Phone (757) 673-6118

Hospital & facility affiliations

  • Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044
  • Bon Secours Harbour View Medical Center Hospital, Suffolk, VA, CCN 490148
  • Bon Secours Maryview Medical Center Hospital, Portsmouth, VA, CCN 490017
  • Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093
  • Riverside Smithfield Hospital Hospital, Smithfield, VA, CCN 490149

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced ENT & Allergy, PC CurrentSince Aug 28, 2021 Accepting new patients
Hampton Roads Otolaryngology Associates PLLC CurrentSince Aug 28, 2021 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince Sep 1, 2025 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince Sep 1, 2025 Accepting new patients

Locations

860 Omni Blvd
Newport News, VA 23606
Phone (757) 369-8138

827 Diligence Dr
Ste 100
Newport News, VA 23606

860 Omni Blvd
Ste 113
Newport News, VA 23606
Phone (757) 327-0657

11842 Rock Landing Dr
Ste 100
Newport News, VA 23606
Phone (757) 873-0338

704 Thimble Shoals Blvd
#30
Newport News, VA 23606
Phone (757) 595-4300

860 Omni Blvd
Ste 401
Newport News, VA 23606
Phone (757) 232-8764

729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077

1030 Champions Way
Suffolk, VA 23435
Phone (757) 673-6118

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12840/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

Organizations & group practices 4

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1740955343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7217 JEANNE DR",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230614355",
            "telephone_number": "757-634-6118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11842 ROCK LANDING DR STE 100",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064437",
            "telephone_number": "757-873-0338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "KRISTI",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024181251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.