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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 30 days.

PHONG LOS PA-C
NPI 1114848728
Physician Assistant in Louisville, KY

Active since July 22, 2026
2100 GARDINER LN, LOUISVILLE, KY 40205(502) 413-8640 Get Directions Write a Review

NPPES record added: July 22, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Phong Los Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHONG LOS PA-C (NPI 1114848728) is an individual physician assistant in Louisville, Kentucky and active in the NPI registry since July 2026.

NPPES Registry Identity

NPI1114848728
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NamePHONG LOSCredential: PA-C
Location Address2100 GARDINER LNLouisville, KY 40205-2962
Mailing Address1245 Abbey LnMount Pleasant, MI 48858-9137 · (989) 289-7977
Phone(502) 413-8640
Sole ProprietorNo
Enumeration DateJuly 22, 2026
NPPES CertifiedJuly 22, 2026
✔ NPI 1114848728 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

2100 GARDINER LN, Louisville, KY 40205
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. AMANDA JETT PHARMD
Pharmacist (Ambulatory Care)
2100 GARDINER LN
LOUISVILLE, KY 40205
Jefferson County (502) 213-8376
DR. MEGHAN MICHELE BODENBERG PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
2100 GARDINER LN
LOUISVILLE, KY 40205
Jefferson County (502) 413-8962
SCHLOEMER SERVICES INC
Social Worker
2100 GARDINER LN, SUITE 314
LOUISVILLE, KY 40205
Jefferson County (502) 640-7533
DR. MIRIAM ANSONG PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
2100 GARDINER LN
LOUISVILLE, KY 40205
Jefferson County (469) 226-6129
DR. HOLLY L BYRNES PHARM.D., BCPS
Pharmacist
2100 GARDINER LN, SULLIVAN UNIVERSITY COLLEGE OF PHARMACY
LOUISVILLE, KY 40205
Jefferson County (502) 413-8648
DR. TERRY ANDREW PEARSON PSY.D.
Psychologist (Clinical)
2100 GARDINER LN, SUITE 307
LOUISVILLE, KY 40205
Jefferson County (502) 456-1990
DR. DREW W. CATES PHARM.D.
Pharmacist
2100 GARDINER LN
LOUISVILLE, KY 40205
Jefferson County (502) 413-8644
DR. JAMES DAVID NASH PHARM.D.
Pharmacist (Pharmacotherapy)
2100 GARDINER LN
LOUISVILLE, KY 40205
Jefferson County (502) 413-8975

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phong Los's NPI number?

The NPI number for Phong Los is 1114848728. It was assigned to this individual provider in the NPPES registry on July 22, 2026.

Where is Phong Los located?

Phong Los practices at 2100 Gardiner Ln, Louisville, KY 40205. The listed phone number is (502) 413-8640.

What is Phong Los's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Phong Los was last updated on July 22, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.