Nicole Kieu Khanh Pham, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

317 Timberleaf Dr
Grand Prairie, TX 75052-6619

Phone

(214) 770-2842

NPI assigned

Jan 18, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Santhi PT Consultants

  • Rehabilitation Clinic/Center
  • McKinney, TX
  • NPI 1962987412
  Medicare reassignment NPD
• Santhi Rehab Consultants PLLC

  • Physical Therapist
  • McKinney, TX
  • NPI 1558192112

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1932960895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 TIMBERLEAF DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750526619",
            "telephone_number": "214-770-2842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 TIMBERLEAF DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750526619",
            "telephone_number": "214-770-2842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "NICOLE",
        "middle_name": "KIEU KHANH",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-18",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James David Peters, D.O.
• Patrice Leeann Pezzullo, RN
• PGP PLLC (Omni Dental PLLC)
• Cuong Duy Pham, OD
• Jocelyn Pham
• Son Pham
• Jennifer Phan, R.PH.
• Pharmacy Corporation of America (OnePoint Patient Care Dallas)
• Pharmacy Corporation of America (Pharmerica)
• McKinley Philip Jr., P.A.

• Occupational Therapist in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.