Douangchay Judy Phangrath, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95009072 Issued in CA

Practice address

4361 Latham St Ste 270
Riverside, CA 92501-4332

Phone

(559) 285-5946

NPI assigned

May 24, 2018

Sex

Female

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

• Judy Phangrath Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, UT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: judy.phangrath@davita.com

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.

• Nightingale Clinical Care, PC

  • Primary Care Clinic/Center
  • Riverside, CA
  • NPI 1972159069
  Medicare reassignment NPD
• Villagehealth DM LLC

  • Case Management Agency
  • Denver, CO
  • NPI 1598273211

  UT

  Medicare reassignment

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1902397045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7197 W SCOTT AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937239397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4361 LATHAM ST STE 270",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014332",
            "telephone_number": "559-285-5946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHANGRATH",
        "first_name": "DOUANGCHAY",
        "middle_name": "JUDY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-24",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JUDY.PHANGRATH@DAVITA.COM",
            "affiliation": "N",
            "address_1": "4361 Latham St Ste 270",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925014332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JUDY",
            "last_name": "PHANGRATH",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Huong Phan, PHARMD
• Jackie Phan
• Jimmy Phan, MD
• Phong Phan, DO
• Thanh Van Thi Phan, RPH
• Pharmerica Drug Systems LLC
• Anita Vasant Phatak, MD
• Lily Phay
• Linda E Phelan, MFTI
• Ariel Phelix-Espinoza

• Family Nurse Practitioner in Riverside, CA
• Providers in Riverside, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.