Active NPI
Connie Ellis Phillips, PT
- Physical Therapist
- Mankato, MN
National Provider Identifier
1124086525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5346
- Practice address
- 1431 Premier Dr
Mankato, MN 56001-6076 - Phone
- (507) 386-6670
- Fax
- (507) 388-8372
- NPI assigned
- May 3, 2006
- Sex
- Female
- Sole proprietor
- No
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 Therapist | 225100000X | 5346 | MN | Primary |
Addresses
Primary practice location
1431 Premier Dr
Mankato, MN 56001-6076
Mailing address
1431 Premier Dr
Mankato, MN 56001-6076
Phone (507) 386-6600
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103183C572 | Other | MN | UCARE MN |
| 448T1PH | Other | MN | BCBS OF MN |
| HP42303 | Other | MN | HEALTH PARTNERS |
| 983181027668 | Other | MN | PREFERRED ONE |
| 6404803 | Other | MN | MEDICA |
| H033 | Other | MN | TRICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopaedic & Fracture Clinic, P.a. | Current | Accepting new patients |
Locations
1431 Premier Dr
Mankato, MN 56001
Phone (507) 386-4277
Interoperability endpoints
- conniephillips@ofc.allscriptsdirect.net
Organizations & group practices 1
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.
-
- Orthopaedic Surgery Physician
- Mankato, MN
- NPI 1659346609
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311292800000",
"number": "1124086525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1431 PREMIER DR",
"city": "MANKATO",
"state": "MN",
"postal_code": "560016076",
"telephone_number": "507-386-6600",
"fax_number": "507-625-5971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1431 PREMIER DR",
"city": "MANKATO",
"state": "MN",
"postal_code": "560016076",
"telephone_number": "507-386-6670",
"fax_number": "507-388-8372"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "CONNIE",
"middle_name": "ELLIS",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-03",
"last_updated": "2011-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "5346",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE MN",
"identifier": "103183C572",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MN",
"identifier": "448T1PH",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP42303",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "983181027668",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "6404803",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "H033",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.