Philip S Fox, MD

Individual provider Active NPI Psychiatry Physician · Kentwood, MI

NPI 1013976596 · NPPES record last updated Jun 25, 2010

Key facts

NPI
1013976596
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatry Physician 2084P0800X
License
4301053214 (MI)
Practice address
1403 60TH St SE
Kentwood, MI 49508-7065
Phone
(616) 719-4488
Fax
(616) 719-4480
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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

Medicare Care Compare profile

Specialty
Psychiatry
Education
Ohio State University College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pine Rest Christian Mental Health Services (354 clinicians)

Practice addresses (Care Compare)

300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000

Hospital & facility affiliations

  • University of Michigan Health - West Hospital · Wyoming, MI · CCN 230236
  • Spectrum Health Hospital · Grand Rapids, MI · CCN 230038

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20060315000060 MI Practitioner - Psychiatry 6406878610 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Rest Christian Mental Health Services Current
since Mar 26, 2008
Accepting new patients
Pine Rest Christian Mental Health Services Current
since Mar 26, 2008
Accepting new patients

Locations

1870 Leonard St NE
Grand Rapids, MI 49505
Phone (616) 956-1122

300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301053214 MI Yes

Addresses

Primary practice location

1403 60TH St SE
Kentwood, MI 49508-7065

Mailing address

1403 60TH St SE
Kentwood, MI 49508-7065
Phone (616) 719-4488

Other identifiers

IdentifierTypeStateIssuer
260D110830OtherMIBCBS

Other providers in Kentwood, MI

All providers in Kentwood, MI · Psychiatry Physician in Michigan

Sources for this page

Verify at the official NPI Registry.