Barry S Phillips, M.D.

Individual provider Active NPI Pediatrics Physician · Newburgh, IN

NPI 1124021571 · NPPES record last updated Jan 9, 2013

Key facts

NPI
1124021571
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
01044946A (IN)
Practice address
4111 Gateway Blvd
Newburgh, IN 47630-8954
Phone
(812) 853-5300
Fax
(812) 858-4660
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

Organizations & group practices 4

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.

Owned or controlled facilities with NPI records 10

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Deaconess Hospital Inc
Evansville, IN · CCN 150082
Hospital Corporate Director Oct 1, 2014
Deaconess Clinic I
Petersburg, IN · CCN 153843
Rural health clinic Corporate Director Nov 20, 2008
Deaconess Clinic Oakland City
Oakland City, IN · CCN 153936
Rural health clinic Corporate Director Oct 1, 2015
Deaconess Clinic Sherman Drive
Princeton, IN · CCN 153934
Rural health clinic Corporate Director Oct 1, 2015
Deaconess Clinic Ft. Branch
Fort Branch, IN · CCN 153933
Rural health clinic Corporate Director Oct 1, 2015
Deaconess Clinic Vail Street
Princeton, IN · CCN 153935
Rural health clinic Corporate Director Oct 1, 2015
Deaconess Clinic Sebree
Sebree, KY · CCN B03929
Rural health clinic Corporate Director Oct 1, 2015
Deaconess Clinic Dixon RHC
Dixon, KY · CCN B03930
Rural health clinic Corporate Director Oct 1, 2015
Deaconess Clinic Morganfield
Morganfield, KY · CCN 183968
Rural health clinic Corporate Director Oct 1, 2015

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20060524000065 IN Practitioner - Pediatric Medicine 6507877909 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01044946AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic Inc Pediatrics Current
since Sep 10, 2014
Accepting new patients
Deaconess Clinic Inc. Current Accepting new patients
Deaconess Clinic, Inc Pediatrics Current
since Sep 10, 2014
Accepting new patients
Deaconess Hospital Inc Past
since Oct 1, 2014
Accepting new patients

Locations

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

4133 Gateway Blvd
Ste 290
Newburgh, IN 47630
Phone (812) 842-2701

4111 Gateway Blvd
Newburgh, IN 47630
Phone (812) 853-5300

4133 Gateway Blvd
Ste 220
Newburgh, IN 47630
Phone (812) 426-9459

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

Interoperability endpoints

  • Direct secure messaging: bphillips2003@direct.deaconess.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01044946A IN Yes

Addresses

Primary practice location

4111 Gateway Blvd
Newburgh, IN 47630-8954

Mailing address

PO Box 1510
Evansville, IN 47706-1510
Phone (812) 853-5300

Other identifiers

IdentifierTypeStateIssuer
200095900MedicaidIN
000000067636OtherINBCBS PIN

Other providers in Newburgh, IN

All providers in Newburgh, IN · Pediatrics Physician in Indiana

Sources for this page

Verify at the official NPI Registry.