Individual provider Active NPI

Christy Ann Phillips

  • Personal Care Attendant
  • Fairmont, WV
National Provider Identifier
1184227688
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Practice address
1105 Marion Ave
Fairmont, WV 26554-2362
Phone
(304) 376-5172
NPI assigned
Nov 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care AttendantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 3747P1801X WV Primary

Addresses

Primary practice location

1105 Marion Ave
Fairmont, WV 26554-2362

Mailing address

1105 Marion Ave
Fairmont, WV 26554-2362
Phone (304) 376-5172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1184227688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 MARION AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265542362",
            "telephone_number": "304-376-5172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 MARION AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265542362",
            "telephone_number": "304-376-5172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "CHRISTY",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.