Melissa Phillips

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2009022126 Issued in MO

Practice address

806 S Kingshighway St
Sikeston, MO 63801-5919

Phone

(573) 471-0110

Fax

(573) 472-1880

NPI assigned

Feb 21, 2012

Last updated

Jun 2, 2014By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

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.

• Missouri Delta Medical Center

  dba Delta Regional Pharmacy

  • Community/Retail Pharmacy
  • Malden, MO
  • NPI 1578371621
  NPD (past)

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401667200000",
    "number": "1073886172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 S KINGSHIGHWAY ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 S KINGSHIGHWAY ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015919",
            "telephone_number": "573-471-0110",
            "fax_number": "573-472-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-21",
        "last_updated": "2014-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2009022126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "MA1733009",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie Pell-Sander, LPC
• Trish R Peterson, FNP-C
• David A. Pfefferkorn, M.D.
• Jacqulyn Christine Phelps, LPC
• Luke William Phillips
• Phoenix Place, LLC
• Heather Elizabeth Polk, APRN
• Salena Victoria Poston
• Michelle E Powers, LCSW
• Erika J Pratt, COTA

• Speech-Language Pathologist in Sikeston, MO
• Providers in Sikeston, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; 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.