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KELLY LORAINE DAUER PHAM MD NPI 1417274689


NPI Information

NPI: 1417274689
Provider Name: KELLY LORAINE DAUER PHAM, MD
Classification: Physical Medicine & Rehabilitation - 2081P0010X
Entity Type: Individual

Specialization: Pediatric Rehabilitation Medicine

PECOS Registration: Yes

Address:
8230 BOONE BLVD STE 170
VIENNA, VA
ZIP 22182
Phone: (571) 310-2502
Get Directions

Kelly Loraine Dauer Pham, MD is a pediatric rehabilitation medicine physical medicine rehabilitation in Vienna, VA with 14 years of experience. The provider is a physiatrist who utilizes an interdisciplinary approach and addresses the prevention, diagnosis, treatment and management of congenital and childhood-onset physical impairments including related or secondary medical, physical, functional, psychosocial and vocational limitations or conditions, with an understanding of the life course of disability. This physician is trained in the identification of functional capabilities and selection of the best of rehabilitation intervention strategies, with an understanding of the continuum of care. Kelly Loraine Dauer Pham, MD NPI is 1417274689. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2010

The provider's business location address is:

8230 BOONE BLVD STE 170
VIENNA, VA
ZIP 22182-621
Phone: (571) 310-2502
Fax: (571) 413-0290

The NPI 1417274689 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/28/2010 and was last updated on 4/13/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208100000XPhysical Medicine & Rehabilitation0101273373VIRGINIANo
2208100000XPhysical Medicine & Rehabilitation185401DISTRICT OF COLUMBIANo
32081P0010XPhysical Medicine & RehabilitationPediatric Rehabilitation MedicineFE60464961WASHINGTONNo
4390200000XStudent in an Organized Health Care Education/Training ProgramNo
52081P0010XPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine0101273373VIRGINIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.