Individual provider Active NPI

Trevor Grant Phillips, M.D.

  • Emergency Medicine Physician
  • Salem, OR
National Provider Identifier
1063633360
Registry record updated Feb 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD28170 Issued in OR
Practice address
890 Oak St SE
Salem Emergency Physicians C/O Ed - Salem Hospital 'a'
Salem, OR 97301-3905
Phone
(503) 561-5634
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD28170 OR Primary

Addresses

Primary practice location

890 Oak St SE
Salem Emergency Physicians C/O Ed - Salem Hospital 'a'
Salem, OR 97301-3905

Mailing address

890 Oak St SE
Salem Emergency Physicians C/O Ed - Salem Hospital 'a'
Salem, OR 97301-3905
Phone (503) 561-5634

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20080708000257 OR Practitioner - Emergency Medicine 8820160864 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Health West Valley CurrentSince Mar 31, 2025 Accepting new patients
Salem Emergency Physicians Service, PC Emergency Medicine CurrentSince Jul 7, 2008 Accepting new patients
Salem Health Past Accepting new patients

Locations

525 SE Washington St
Dallas, OR 97338
Phone (503) 623-7344

1601 Monmouth St
Ste 100
Independence, OR 97351
Phone (503) 623-8301

890 Oak St SE
Bldg A
Salem, OR 97301
Phone (503) 370-5634

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518480000000",
    "number": "1063633360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 OAK ST SE",
            "address_2": "SALEM EMERGENCY PHYSICIANS C/O ED - SALEM HOSPITAL 'A'",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013905",
            "telephone_number": "503-561-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 OAK ST SE",
            "address_2": "SALEM EMERGENCY PHYSICIANS C/O ED - SALEM HOSPITAL 'A'",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013905",
            "telephone_number": "503-561-5634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "TREVOR",
        "middle_name": "GRANT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2018-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD28170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.