NPIMap

Organization Active NPI

Terrell R Phillips DO Inc

  • Anesthesiology Physician
  • Oklahoma City, OK
National Provider Identifier
1114942810
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2427 Issued in OK
Legal business name
TERRELL R PHILLIPS DO INC
Practice address
401 SW 80TH St
BLDG D Ste 200
Oklahoma City, OK 73139-8122
Phone
(405) 775-9350
Fax
(405) 775-9360
NPI assigned
Jul 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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

Authorized official

Name
Terry Timmons
Title
Operations Manager
Phone
(405) 775-9350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X 2427 OK Primary

Addresses

Primary practice location

401 SW 80TH St
BLDG D Ste 200
Oklahoma City, OK 73139-8122

Mailing address

PO Box 357
Lowell, AR 72745-0357
Phone (405) 775-9350

Other identifiers 2

IdentifierTypeStateIssuer
352456400OtherOKDOL
100851270AMedicaidOK

National Provider Directory

National Provider Directory

Locations

3705 W Memorial Rd
Ste 302
Oklahoma City, OK 73134
Phone 4057759350100

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590969600000",
    "number": "1114942810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 357",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727450357",
            "telephone_number": "405-775-9350",
            "fax_number": "405-775-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 SW 80TH ST",
            "address_2": "BLDG D STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731398122",
            "telephone_number": "405-775-9350",
            "fax_number": "405-775-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRELL R PHILLIPS DO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A",
        "authorized_official_last_name": "TIMMONS",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "405-775-9350"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "2427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL",
            "identifier": "352456400",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100851270A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; 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.