Misty M. Phillips, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036117503 Issued in IL

Practice address

2532 Farragut Dr
Springfield, IL 62704-1433

Phone

(217) 528-7541

NPI assigned

Jan 12, 2007

Last updated

May 21, 2020By 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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

88.83 of 100Reported as apm

Quality

75.65

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: misty.phillips.1@28977.direct.athenahealth.com

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Springfield Clinic LLP

  • Rural Health Clinic/Center
  • Raymond, IL
  • NPI 1013255942

  Limited Partnership Interest

  CMS ownership
• Springfield Clinic LLP

  • Rural Health Clinic/Center
  • Macomb, IL
  • NPI 1730831157

  Limited Partnership Interest

  CMS ownership
• Springfield Clinic LLP

  dba Springfield Clinic Rural Health Neoga

  • Rural Health Clinic/Center
  • Neoga, IL
  • NPI 1972790889

  Limited Partnership Interest

  CMS ownership
• Springfield Clinic, LLP

  • Rural Health Clinic/Center
  • Lincoln, IL
  • NPI 1518143452

  Limited Partnership Interest

  CMS ownership
• Springfield Clinic, LLP

  • Rural Health Clinic/Center
  • Nokomis, IL
  • NPI 1922285600

  Limited Partnership Interest

  CMS ownership

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.

• Springfield Clinic, LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1780638478
  Medicare reassignment NPD

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1053461657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2532 FARRAGUT DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627041433",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MISTY",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036117503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036117503",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mistyphillips@sfc.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "2532 Farragut Dr",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627041433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Philco Dental Group LLC Springfield West
• Jacob Philip, DDS
• Phillip M. Jensen, D.M.D., P.C.
• Phillips Investments, LLC - Springfield Operations Series
• Hannah Marie Phillips
• Paul Phillips, M.D.
• Phoenix Sleep Solutions
• Physicians Group Associates S C
• Physicians Group Associates S C
• Physicians Group Associates S C

• Pediatrics Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.