Active NPI
Nguyen Ngtam, M.D.
- Family Medicine Physician
- Richmond, VA
National Provider Identifier
1780970814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0116023992
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151104002146 | VA | Practitioner - Family Practice | 6608023338 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0116023992 | VA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vera Whole Health Wa, PC | Current | Accepting new patients |
Locations
3810 W Broad St
Ste 104
Richmond, VA 23230
Phone (804) 655-6008
Interoperability endpoints
- 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.
-
- Primary Care Clinic/Center
- Richmond, VA
- NPI 1528879731
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.