Teresa Thi Phan, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-13002 Issued in NC

Practice address

16645 Birkdale Commons Pkwy
Ste 100
Huntersville, NC 28078-5669

Phone

(704) 801-7390

NPI assigned

Oct 19, 2018

Last updated

Jul 15, 2024By the provider in NPPES

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 NC

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 1

Specialty

Physician Assistant

Education

University of South Carolina School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atrium Health North Market Network LLCGroup PAC ID 1557743440, 158 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: tphan1188709@carolinashealthcaresystem.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Atrium Health North Market Network LLC

  dba Atrium Health Primary Care One Health Family Medicine

  • Family Medicine Physician
  • Mooresville, NC
  • NPI 1871112920
  Medicare reassignment Care Compare group
• Carolinas Physicians Network Inc

  dba Atrium Health Diabetes Prevention

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1437038544
  NPD (past)
• Carolinas Physicians Network Inc

  dba Atrium Health Primary Care One Health Family Medicine

  • Family Medicine Physician
  • Mooresville, NC
  • NPI 1649890468
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carolinas Medical Center

  dba Atrium Health Behavioral Health

  • Psychiatric Hospital Unit
  • Charlotte, NC
  • NPI 1053358945
  Care Compare affiliation
• Carolinas Medical Center

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1295789907
  Care Compare affiliation
• Carolinas Medical Center

  dba Atrium Health Mercy

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1376985135
  Care Compare affiliation
• Carolinas Medical Center

  dba Levine Children's Hospital Pediatrics

  • Children's Rehabilitation Hospital
  • Charlotte, NC
  • NPI 1699829887
  Care Compare affiliation
• Carolinas Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
  • NPI 1720029705

  Hospital

  Care Compare affiliation
• Carolinas Medical Center

  dba Atrium Health Laboratory

  • Clinical Medical Laboratory
  • Charlotte, NC
  • NPI 1811005150

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1942776711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16645 BIRKDALE COMMONS PKWY",
            "address_2": "STE 100",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280785669",
            "telephone_number": "704-801-7390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13620 Reese Blvd E",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280786417",
            "country_code": "US",
            "telephone_number": "704-801-7340",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Professional Park Dr",
            "address_2": "Ste 400",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281175603",
            "country_code": "US",
            "telephone_number": "704-801-7360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9611 Sherrill Estates Rd",
            "address_2": "Ste B",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280786485",
            "country_code": "US",
            "telephone_number": "704-801-1150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10226 Couloak Dr",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282167675",
            "country_code": "US",
            "telephone_number": "704-801-7380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "TERESA",
        "middle_name": "THI",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-19",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-13002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Uma Periyanayagam, M.D
• Michael Logan Pettus, MD
• Jacita Booker Petway, PSY.D.
• Alycia Lynn Pfeiffer, DPT
• Kaitlin Anne Phelps
• Olivia Catherine Philippart, PHARMD, BCTXP
• Erin Phillips
• Sam Phillips, PHARM D
• Stan D. Phillips, M.D

• Physician Assistant in Huntersville, NC
• Providers in Huntersville, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.