Khoa Dang Pham, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT.0023938 Issued in CO

Practice address

1650 38TH St Ste 100E
Boulder, CO 80301-2624

Phone

(720) 213-8001

NPI assigned

Oct 21, 2024

Last updated

Oct 21, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Khoa Dang Pham Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1881415164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6652 W HAMILTON DR",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802275336",
            "telephone_number": "512-903-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 38TH ST STE 100E",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012624",
            "telephone_number": "720-213-8001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10488 W Centennial Rd Ste 307",
            "address_purpose": "LOCATION",
            "city": "Littleton",
            "state": "CO",
            "postal_code": "801274293",
            "country_code": "US",
            "telephone_number": "720-220-1687",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8805 W 14th Ave Ste 320",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802154850",
            "country_code": "US",
            "telephone_number": "720-213-8001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "KHOA",
        "middle_name": "DANG",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "MT.0023938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KHOA",
            "last_name": "PHAM",
            "middle_name": "DANG",
            "prefix": "MR.",
            "credential": "LMT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Massage Therapist in Boulder, CO
• Providers in Boulder, CO by specialty
• Massage Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.