Individual provider Active NPI

Sue V. Phillips, D.C.

  • Nutrition Chiropractor
  • Twin Falls, ID
National Provider Identifier
1083629448
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
CHIA 761 Issued in ID
Practice address
1625 Addison Ave E
Twin Falls, ID 83301-5343
Phone
(208) 735-2442
Fax
(208) 735-9030
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X CHIA 761 ID Primary

Addresses

Primary practice location

1625 Addison Ave E
Twin Falls, ID 83301-5343

Mailing address

1625 Addison Ave E
Twin Falls, ID 83301-5343
Phone (208) 735-2442

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

State licenses

LicenseStateTypeSpecialty
CHIA 761IDMDNutrition Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083629448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 ADDISON AVE E",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015343",
            "telephone_number": "208-735-2442",
            "fax_number": "208-735-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 ADDISON AVE E",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015343",
            "telephone_number": "208-735-2442",
            "fax_number": "208-735-9030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "SUE",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "ID",
            "license": "CHIA 761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.