Individual provider Active NPI

Nguyen Ngtam, M.D.

  • Family Medicine Physician
  • Richmond, VA
National Provider Identifier
1780970814
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0116023992 Issued in VA
Practice address
3810 W Broad St Ste 104
Richmond, VA 23230-3927
Phone
(804) 655-6008
Fax
(833) 428-7575
NPI assigned
Jun 27, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0116023992 VA Primary

Addresses

Primary practice location

3810 W Broad St Ste 104
Richmond, VA 23230-3927

Mailing address

3810 W Broad St Ste 104
Richmond, VA 23230-3927
Phone (804) 655-6008

Other practice location 1

403 Shadow Creek Ln
Manakin Sabot, VA 23103-2537
Phone (804) 413-1050

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151104002146 VA Practitioner - Family Practice 6608023338

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0116023992VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vera Whole Health Wa, PC CurrentSince Apr 27, 2025 Accepting new patients

Locations

3810 W Broad St
Ste 104
Richmond, VA 23230
Phone (804) 655-6008

Interoperability endpoints

  • Direct secure messaging: nguyen.ngtam.1@32512.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1780970814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 W BROAD ST STE 104",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232303927",
            "telephone_number": "804-655-6008",
            "fax_number": "833-428-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 W BROAD ST STE 104",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232303927",
            "telephone_number": "804-655-6008",
            "fax_number": "833-428-7575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "403 Shadow Creek Ln",
            "address_purpose": "LOCATION",
            "city": "Manakin Sabot",
            "state": "VA",
            "postal_code": "231032537",
            "country_code": "US",
            "telephone_number": "804-413-1050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGTAM",
        "first_name": "NGUYEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-27",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0116023992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.