Individual provider Active NPI

Dawn Phillips, MPT

  • Physical Therapist
  • Fairbury, IL
National Provider Identifier
1144278532
Registry record updated Nov 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-014912 Issued in IL
Practice address
215 W Locust St
Fairbury, IL 61739-1550
Phone
(815) 692-3941
NPI assigned
May 5, 2006
Last updated
Nov 25, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070-014912 IL Primary

Addresses

Primary practice location

215 W Locust St
Fairbury, IL 61739-1550

Mailing address

706 Iaa Dr Apt 5
Bloomington, IL 61701-2265
Phone (309) 453-7542

Other identifiers 1

IdentifierTypeStateIssuer
070-014912OtherILIL LICENSE NO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170120001174 IL Practitioner - Physical Therapist in Private Practice 0840572194 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Turning Point Therapies IncGroup PAC ID 4880750207, 3 clinicians

Practice addresses (Care Compare)

215 W Locust St
Fairbury, IL 61739-1550
Phone (815) 692-2270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-014912ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Spine and Pain Center, LTD. CurrentSince Jan 15, 2022 Accepting new patients
Turning Point Therapies Inc Physical Therapist CurrentSince Dec 2, 2016 Accepting new patients
McLean County Foot & Ankle, LTD. Past Accepting new patients

Locations

3801 General Electric Rd
Ste 4
Bloomington, IL 61704
Phone (309) 319-2341

215 W Locust St
Fairbury, IL 61739
Phone (815) 692-2270

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11124/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227571200000",
    "number": "1144278532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 IAA DR APT 5",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617012265",
            "telephone_number": "309-453-7542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W LOCUST ST",
            "city": "FAIRBURY",
            "state": "IL",
            "postal_code": "617391550",
            "telephone_number": "815-692-3941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "DAWN",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2008-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-014912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL LICENSE NO",
            "identifier": "070-014912",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbury, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.