NPIMap

Individual provider Active NPI

Hiep Pham

  • Geriatric Medicine (Family Medicine) Physician
  • Matthews, NC
National Provider Identifier
1780690503
Registry record updated Apr 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
9601434 Issued in NC
Practice address
2030 Windsor Run LN
Matthews, NC 28105-0054
Phone
(704) 443-6250
Fax
(704) 443-6279
NPI assigned
Aug 1, 2006
Last updated
Apr 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 22778 SC
Geriatric Medicine (Family Medicine) Physician 207QG0300X 9601434 NC Primary

Addresses

Primary practice location

2030 Windsor Run LN
Matthews, NC 28105-0054

Mailing address

5730 Executive Dr Ste 230
Catonsville, MD 21228-1762
Phone (410) 402-2379

Other practice location 1

700 W Roosevelt Blvd
Monroe, NC 28110-3437
Phone (704) 512-5363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040728001700 NC Practitioner - Geriatric MedicinePractitioner - Family PracticePractitioner - Hospice/Palliative Care 5193709095 Reassigns benefits to 1 organization
I20090919000009 SC Practitioner - Family PracticePractitioner - Hospice/Palliative CarePractitioner - Geriatric Medicine 5193709095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine, Hospice/Palliative Care
Education
University of South Florida College of Medicine, 1987
Medicare assignment
May accept Medicare assignment
Group practices
Providence House Calls LLCGroup PAC ID 1759528250, 20 clinicians
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

500 Lakeshore Pkwy
Rock Hill, SC 29730-4273
Phone (803) 818-6955

600 Hospital Dr
Monroe, NC 28112-6000
Phone (704) 993-2240

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9601434NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Nov 20, 2017 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Nov 20, 2017 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Covenant Elder Health Services & Management LLC Current Accepting new patients
Providence House Calls LLC CurrentSince Jul 1, 2025 Accepting new patients
Senior Health Connection Geriatric Medicine Past Accepting new patients
Greenville Health System Past Accepting new patients

Locations

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

7903 Providence Rd
Ste 100
Charlotte, NC 28277
Phone (704) 316-4460

1550 Faulk St
Ste 1500
Monroe, NC 28112
Phone (704) 302-9700

600 Hospital Dr
Monroe, NC 28112
Phone (704) 283-3100

700 W Roosevelt Blvd
Monroe, NC 28110
Phone (704) 292-2100

500 Lakeshore Pkwy
Rock Hill, SC 29730
Phone (803) 818-6900

634 Fairview Rd
Simpsonville, SC 29680
Phone (843) 851-3126

Interoperability endpoints

  • Direct secure messaging: hpham499860@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1780690503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5730 EXECUTIVE DR STE 230",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212281762",
            "telephone_number": "410-402-2379",
            "fax_number": "410-469-3085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 WINDSOR RUN LN",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281050054",
            "telephone_number": "704-443-6250",
            "fax_number": "704-443-6279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 W Roosevelt Blvd",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "NC",
            "postal_code": "281103437",
            "country_code": "US",
            "telephone_number": "704-512-5363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "HIEP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "SC",
            "license": "22778",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NC",
            "license": "9601434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.