Active NPI
Emily Phillips, RDN, PA-C
- Physician Assistant
- Long Beach, CA
National Provider Identifier
1073055307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 62054
- Practice address
- 3024 E 6TH St Apt 2
Long Beach, CA 90814-8592 - Phone
- (562) 674-6964
- NPI assigned
- Nov 17, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 62054 | CA | Primary |
| Registered Dietitian | 133V00000X |
Addresses
Primary practice location
3024 E 6TH St Apt 2
Long Beach, CA 90814-8592
Mailing address
7400 Artesia Blvd Apt 1508
Buena Park, CA 90621-3968
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62054 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Interoperability endpoints
- ephillips2035093@oc.providencedirect.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671753600000",
"number": "1073055307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7400 ARTESIA BLVD APT 1508",
"city": "BUENA PARK",
"state": "CA",
"postal_code": "906213968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3024 E 6TH ST APT 2",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908148592",
"telephone_number": "562-674-6964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "EMILY",
"credential": "RDN, PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-17",
"last_updated": "2022-12-23",
"certification_date": "2022-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "62054",
"primary": true
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.