Philip Clark Brittain, DO

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

02001508 Issued in IN

Practice address

642 S Walker St
Bloomington, IN 47403-2158

Phone

(812) 331-9160

Fax

(812) 336-0277

NPI assigned

Sep 15, 2005

Sex

Male

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 28, 2023 through Nov 28, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Clark Brittain DO PC

  • Gynecology Physician
  • Bloomington, IN
  • NPI 1215908827
  NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1073508040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 S WALKER ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032158",
            "telephone_number": "812-331-9160",
            "fax_number": "812-336-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 S WALKER ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032158",
            "telephone_number": "812-331-9160",
            "fax_number": "812-336-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRITTAIN",
        "first_name": "PHILIP",
        "middle_name": "CLARK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IN",
            "license": "02001508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200016270",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pbrittain@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "642 S Walker St",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474032158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Esther J Briggs, CPNP
• Bright Life Hearing Care, LLC
• Brinegar Eye Care, LLC
• Sydney N Brinegar, RBT
• Kelly L Brinkley, PT
• Samantha Marie Britton, DPT
• Isaiah Broden
• Annette Therese Broderick, DPT
• Noah Bronnert
• Clifford Brooks, O.D.

• Gynecology Physician in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Gynecology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.