Phyllis Eason, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

PT12912 Issued in ND

Practice address

100 4TH St S
Fargo, ND 58103-1929

Phone

(701) 234-3100

Fax

(701) 234-3120

NPI assigned

Feb 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA, ND, MO, CA4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 4

Specialty

Psychiatry

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SSM Regional Health Services 165 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St. Mary'S Hospital - Jefferson City Hospital, Jefferson City, MO, CCN 260011

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• SSM Regional Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jefferson City, MO
  • NPI 1053368159

  MO

  Medicare reassignment Care Compare group NPD
• Altru Health System

  • Clinic/Center
  • Grand Forks, ND
  • NPI 1043309552

  ND

  Medicare reassignment NPD
• Cep America - Psychiatry PC

  • Psychiatry Physician
  • Santa Maria, CA
  • NPI 1538757232

  CA, Psychiatry

  Medicare reassignment NPD
• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464

  GA

  Medicare reassignment NPD
• Poplar Bluff Hma Physician Management, LLC

  • Family Medicine Physician
  • Poplar Bluff, MO
  • NPI 1598710147

  MO, Psychiatry

  Medicare reassignment NPD
• SSM Regional Health Services

  • Community/Retail Pharmacy
  • Jefferson City, MO
  • NPI 1922119726
  Care Compare group NPD
• SSM Regional Health Services

  • General Acute Care Hospital
  • Jefferson City, MO
  • NPI 1518065523
  Care Compare group NPD (past)
• SSM Regional Health Services

  • Multi-Specialty Clinic/Center
  • Jefferson City, MO
  • NPI 1033135496
  Care Compare group
• SSM Regional Health Services

  • General Practice Physician
  • Jefferson City, MO
  • NPI 1043450711
  Care Compare group
• SSM Regional Health Services

  • Multi-Specialty Clinic/Center
  • Jefferson City, MO
  • NPI 1336555275
  Care Compare group
• SSM Regional Health Services

  • Clinic/Center
  • Jefferson City, MO
  • NPI 1396782587
  Care Compare group
• SSM Regional Health Services

  • Family Medicine Physician
  • Jefferson City, MO
  • NPI 1396886065
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• SSM Regional Health Services

  • General Acute Care Hospital
  • Jefferson City, MO
  • NPI 1518065523

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1174596746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2168",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581072168",
            "telephone_number": "701-234-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 4TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031929",
            "telephone_number": "701-234-3100",
            "fax_number": "701-234-3120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 NE Mother Joseph Pl",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986643200",
            "country_code": "US",
            "telephone_number": "360-514-3191",
            "fax_number": "360-729-3372",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2016 S Main St",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "MO",
            "postal_code": "644682655",
            "country_code": "US",
            "telephone_number": "660-562-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EASON",
        "first_name": "PHYLLIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "043926",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "71925",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2015042689",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD61499166",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C170232",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ND",
            "license": "PT12912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18207",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174596746",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Fargo, ND
• Psychiatry Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.
• 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.