Individual provider Active NPI

Glenn Stephen McPhillips, DPM

  • Foot Surgery Podiatrist
  • Selma, AL
National Provider Identifier
1104821222
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
248 Issued in AL
Practice address
6 Office Park Cir
Selma, AL 36701-6506
Phone
(334) 872-5636
Fax
(334) 872-5199
NPI assigned
Jun 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 248 AL Primary

Addresses

Primary practice location

6 Office Park Cir
Selma, AL 36701-6506

Mailing address

6 Office Park Cir
Selma, AL 36701-6506
Phone (334) 872-5636

Other identifiers 1

IdentifierTypeStateIssuer
MC051552783MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041227000512 AL Practitioner - Podiatry 8729071097 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Health Medical Program, Inc. Current Accepting new patients
Rural Health Medical Program, Inc Current Accepting new patients
Rural Health Medical Program, Inc Current Accepting new patients
Rural Health Medical Program, Inc. Current Accepting new patients
Rural Health Medical Program, Inc Current Accepting new patients
Rural Health Medical Program, Inc CurrentSince Aug 25, 2018 Accepting new patients
Rural Health Medical Program, Inc Current Accepting new patients
Rural Health Medical Program, Inc Current Accepting new patients
Rural Health Medical Program, Inc. CurrentSince Aug 25, 2018 Accepting new patients

Locations

2210 Highway 221
Camden, AL 36726
Phone (334) 682-5772

1310 Washington St
Marion, AL 36756
Phone (334) 683-2073

3040 S Alabama Ave
Monroeville, AL 36460
Phone (334) 874-7428

867 County Road 59
Pine Apple, AL 36768
Phone (251) 746-2197

101 Park Pl
Selma, AL 36701
Phone (334) 526-2200

6 Office Park Cir
Selma, AL 36701
Phone (334) 872-5636

111 Main St
Thomaston, AL 36783
Phone (334) 627-3497

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13116/brand/1/csg/1/fhir/r4

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1104821222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 OFFICE PARK CIR",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367016506",
            "telephone_number": "334-872-5636",
            "fax_number": "334-872-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 OFFICE PARK CIR",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367016506",
            "telephone_number": "334-872-5636",
            "fax_number": "334-872-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCPHILLIPS",
        "first_name": "GLENN",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "AL",
            "license": "248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MC051552783",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Selma, AL

Sources for this page

Verify at the official NPI Registry.