Vickie Lynn Phillips, MEDICAL ESTHETICIAN

Primary specialty

Medical Art Specialist/TechnologistTaxonomy code 246ZA2600X

Practice address

3637 Medina Rd Ste 203
Medina, OH 44256-8155

Phone

(330) 592-8978

NPI assigned

Jun 6, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1622937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622937600000",
    "number": "1174190490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3637 MEDINA RD STE 203",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568155",
            "telephone_number": "330-592-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3637 MEDINA RD STE 203",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568155",
            "telephone_number": "330-592-8978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "VICKIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MEDICAL ESTHETICIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-06",
        "last_updated": "2021-06-06",
        "certification_date": "2021-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZA2600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Art, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vickielynn@sssnet.com",
            "affiliation": "N",
            "address_1": "3637 Medina Rd Ste 203",
            "city": "Medina",
            "state": "OH",
            "country_code": "US",
            "postal_code": "442568155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pfister Functional Medicine & Chiropractic LLC
• Anthony James Pfister, D.C., APRN, RN
• Charles Russell Pfister, DDS MS
• Anthony John Phillips, PT
• Joshua Phillips
• Kevin Benjamin Piatt
• Theresa Marie Piatt, PT
• Rachel Piero
• Randy Pierpoint, PRS
• Andrea Pinter, LPN

• Medical Art Specialist/Technologist in Medina, OH
• Providers in Medina, OH by specialty
• Medical Art Specialist/Technologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2021; 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.