Active NPI
Sidney Hornor Phillips, M.D.
- Psychiatry Physician
- New Haven, CT
National Provider Identifier
1003950239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 019539
- Practice address
- 234 Church St
Suite #300
New Haven, CT 06510-1804 - Phone
- (203) 865-8246
- NPI assigned
- Feb 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 019539 | CT | Primary |
Addresses
Primary practice location
234 Church St
Suite #300
New Haven, CT 06510-1804
Mailing address
234 Church St
Suite #300
New Haven, CT 06510-1804
Phone (203) 865-8246
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jul 21, 2015 through Jul 21, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019539 | CT | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003950239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "234 CHURCH ST",
"address_2": "SUITE #300",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065101804",
"telephone_number": "203-865-8246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "234 CHURCH ST",
"address_2": "SUITE #300",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065101804",
"telephone_number": "203-865-8246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "SIDNEY",
"middle_name": "HORNOR",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "019539",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.