Peggy Marie Phillips, RN-BC, ANP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

518144 Issued in TX

Practice address

17448 Highway 3
Suite 136
Webster, TX 77598-4197

Phone

(281) 338-4443

Fax

(281) 338-8821

NPI assigned

Oct 26, 2010

Last updated

Aug 26, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15688/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
• Direct secure messaging: pphillips@scps-tx.direct.office.nextgen.com

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.

• Space City Pain Specialists

  • Pain Medicine (Anesthesiology) Physician
  • Webster, TX
  • NPI 1790739472
  NPD

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1134429046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17448 HIGHWAY 3",
            "address_2": "SUITE 136",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984141",
            "telephone_number": "281-338-4443",
            "fax_number": "281-338-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17448 HIGHWAY 3",
            "address_2": "SUITE 136",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984197",
            "telephone_number": "281-338-4443",
            "fax_number": "281-338-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "PEGGY",
        "middle_name": "MARIE",
        "credential": "RN-BC, ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-26",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "1010004",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "518144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280521003",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280521004",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P01197024",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "832N36",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1134429046",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280521001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280521002",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00988009",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Philip Eugene Rosen
• Tharun Philip
• Cynthia B Phillips, DO
• Diane C Phillips, AU.D., CCC-A
• Jayla Michelle Phillips, MD
• Melissa Marie Pichardo
• Morgan Pifer
• Zoe Tramel Pilares, MD
• Regina Rajagopala Pillai, M.D.
• Stephanie Catherine Pilsner, SLP-CCC, BCBA

• Adult Health Nurse Practitioner in Webster, TX
• Providers in Webster, TX by specialty
• Adult Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.