Active NPI
Shelby Phillips
- Physical Medicine & Rehabilitation Physician
- Pittsfield, MA
National Provider Identifier
1093279309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 9602
- Practice address
- 169 Valentine Rd
Pittsfield, MA 01201-3042 - Phone
- (419) 315-5870
- NPI assigned
- Jan 31, 2019
- Last updated
- Jan 31, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 9602 | MA | Primary |
Addresses
Primary practice location
169 Valentine Rd
Pittsfield, MA 01201-3042
Mailing address
607 W 1St St
Woodville, OH 43469-1004
Phone (419) 559-9970
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9602 | MA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548892800000",
"number": "1093279309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "607 W 1ST ST",
"city": "WOODVILLE",
"state": "OH",
"postal_code": "434691004",
"telephone_number": "419-559-9970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "169 VALENTINE RD",
"city": "PITTSFIELD",
"state": "MA",
"postal_code": "012013042",
"telephone_number": "419-315-5870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "SHELBY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-31",
"last_updated": "2019-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "MA",
"license": "9602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittsfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.