NPIMap

Individual provider Active NPI

Barry S Phillips, M.D.

  • Pediatrics Physician
  • Newburgh, IN
National Provider Identifier
1124021571
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01044946A Issued in IN
Practice address
4111 Gateway Blvd
Newburgh, IN 47630-8954
Phone
(812) 853-5300
Fax
(812) 858-4660
NPI assigned
May 31, 2005
Last updated
Jan 9, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Specialties & licenses 1

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

Addresses

Primary practice location

4111 Gateway Blvd
Newburgh, IN 47630-8954

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01044946AINMDPediatrics Physician

Practice roles

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

Locations

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

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

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

Interoperability endpoints

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

Ownership & related parties

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 IncEvansville, IN, CCN 150082 Hospital Corporate Director Oct 1, 2014
Deaconess Clinic IPetersburg, IN, CCN 153843 Rural health clinic Corporate Director Nov 20, 2008
Deaconess Clinic Oakland CityOakland City, IN, CCN 153936 Rural health clinic Corporate Director Oct 1, 2015
Deaconess Clinic Sherman DrivePrinceton, IN, CCN 153934 Rural health clinic Corporate Director Oct 1, 2015
Deaconess Clinic Ft. BranchFort Branch, IN, CCN 153933 Rural health clinic Corporate Director Oct 1, 2015
Deaconess Clinic Vail StreetPrinceton, IN, CCN 153935 Rural health clinic Corporate Director Oct 1, 2015
Deaconess Clinic SebreeSebree, KY, CCN B03929 Rural health clinic Corporate Director Oct 1, 2015
Deaconess Clinic Dixon RHCDixon, KY, CCN B03930 Rural health clinic Corporate Director Oct 1, 2015
Deaconess Clinic MorganfieldMorganfield, KY, CCN 183968 Rural health clinic Corporate Director Oct 1, 2015

Owned or controlled facilities with NPI records 10

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1124021571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061510",
            "telephone_number": "812-853-5300",
            "fax_number": "812-858-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 GATEWAY BLVD",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308954",
            "telephone_number": "812-853-5300",
            "fax_number": "812-858-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "BARRY",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01044946A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, IN

Sources for this page

Verify at the official NPI Registry.