Individual provider Active NPI

Karen Elaine Phillips, FNP-C

  • Family Nurse Practitioner
  • Terre Haute, IN
National Provider Identifier
1063479624
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28078396A Issued in IN
Practice address
670 Margaret Ave
Terre Haute, IN 47802-3854
Phone
(866) 389-2727
Fax
(401) 216-3854
NPI assigned
Apr 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28078396A IN Primary

Addresses

Primary practice location

670 Margaret Ave
Terre Haute, IN 47802-3854

Mailing address

670 Margaret Ave
Terre Haute, IN 47802-3854
Phone (866) 389-2727

Other identifiers 3

IdentifierTypeStateIssuer
1063479624OtherNPI
200817080AMedicaidIN
15-3899OtherCMS REGISTRATION NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1063479624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 MARGARET AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478023854",
            "telephone_number": "866-389-2727",
            "fax_number": "401-216-3854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 MARGARET AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478023854",
            "telephone_number": "866-389-2727",
            "fax_number": "401-216-3854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "KAREN",
        "middle_name": "ELAINE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28078396A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1063479624",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200817080A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS REGISTRATION NUMBER",
            "identifier": "15-3899",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.