Active NPI
Nam Thanh Ly, M.D.
- Pulmonary Disease Physician
- Portsmouth, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 01054164A
- Practice address
- 620 John Paul Jones Cir
Portsmouth, VA 23708-2111 - Phone
- (757) 953-2266
- NPI assigned
- Jan 27, 2006
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 0101245794 | VA | |
| Pulmonary Disease Physician | 207RP1001X | 0101245794 | VA | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 01054164A | IN | |
| Sleep Medicine (Internal Medicine) Physician | 207RS0012X | 0101245794 | VA | |
| Pulmonary Disease Physician | 207RP1001X | 01054164A | IN | Primary |
Addresses
Primary practice location
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Mailing address
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Phone (757) 953-2266
Other practice location 1
600 Gresham Dr Ste 8630B
Norfolk, VA 23507-1904
Phone (757) 388-6115
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101245794 | VA | MD | Critical Care Medicine (Internal Medicine) Physician |
| 01054164A | IN | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sentara Medical Group | Pulmonary Disease | Current | Accepting new patients |
| Bayview Physician Services, PC | Critical Care Medicine | Current | Accepting new patients |
| Bayview Physician Services, PC | Current | Accepting new patients |
Locations
111 Mill Creek Pkwy
Chesapeake, VA 23323
Phone (757) 558-8210
3241 Western Branch Blvd
Chesapeake, VA 23321
Phone (757) 686-3500
850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162
600 Gresham Dr
Ste 8630B
Norfolk, VA 23507
Phone (757) 338-6115
1168 First Colonial Rd
Ste 101
Virginia Beach, VA 23454
Phone (757) 481-2515
Interoperability endpoints
- nly44518@direct.sentara.net
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Hospital for Extended Recovery | Hospital | Corporate Director | Jan 1, 2024 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Long Term Care Hospital
- Norfolk, VA
- NPI 1942266515
Corporate Director
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Chesapeake, VA
- NPI 1508813387
Critical Care Medicine
-
- Radiology Clinic/Center
- Suffolk, VA
- NPI 1699865626
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653004800000",
"number": "1780655837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 JOHN PAUL JONES CIR",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237082111",
"telephone_number": "757-953-2266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 JOHN PAUL JONES CIR",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237082111",
"telephone_number": "757-953-2266"
}
],
"practiceLocations": [
{
"address_1": "600 Gresham Dr Ste 8630B",
"address_purpose": "LOCATION",
"city": "Norfolk",
"state": "VA",
"postal_code": "235071904",
"country_code": "US",
"telephone_number": "757-388-6115",
"fax_number": "757-275-9998",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LY",
"first_name": "NAM",
"middle_name": "THANH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-27",
"last_updated": "2022-05-20",
"certification_date": "2022-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "VA",
"license": "0101245794",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "VA",
"license": "0101245794",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "IN",
"license": "01054164A",
"primary": false
},
{
"code": "207RS0012X",
"taxonomy_group": "",
"desc": "Internal Medicine, Sleep Medicine",
"state": "VA",
"license": "0101245794",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "IN",
"license": "01054164A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portsmouth, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.