Jonathan Phillip

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

195-123 Issued in WI

Practice address

211 N Commercial St
Neenah, WI 54956-2616

Phone

(920) 236-4600

NPI assigned

Nov 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• County of Winnebago

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oshkosh, WI
  • NPI 1508960675
  NPD (past)
• Winnebago County

  • Public Health or Welfare Agency
  • Winnebago, WI
  • NPI 1154318657
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154497428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2187",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549032187",
            "telephone_number": "920-236-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N COMMERCIAL ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562616",
            "telephone_number": "920-236-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIP",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "195-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42156000",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42139300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kristina Lynn Petrasko
• Phoenix Chiropractic and Wellness, LLC
• Gabrielle Alivia Piechocki
• Andrew Pierson
• Steven F Pingel, PT
• Krystina Marie Pischke

• Addiction (Substance Use Disorder) Counselor in Neenah, WI
• Providers in Neenah, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.