NP Primary Care Practice, PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

NP PRIMARY CARE PRACTICE, PLLC

Practice address

2091 Fairfield Avenue
Suite #1
Bridgeport, CT 06605-2246

Phone

(203) 572-7491

NPI assigned

Jul 23, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Nicole J. Phillips, DNP, APRN, FNP-CNPI 1649684036

Title

Medical Director/Owner

Phone

(203) 572-7491

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicole J. Phillips, DNP

  • Family Nurse Practitioner
  • Bridgeport, CT
  • NPI 1649684036
  NPD Authorized official

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626998400000",
    "number": "1205409463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2091 FAIRFIELD AVENUE",
            "address_2": "SUITE #1",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066052246",
            "telephone_number": "203-572-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2091 FAIRFIELD AVENUE",
            "address_2": "SUITE #1",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066052246",
            "telephone_number": "203-572-7491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NP PRIMARY CARE PRACTICE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/OWNER",
        "authorized_official_telephone_number": "203-572-7491",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, APRN, FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Primary Care Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.