Individual provider Active NPI

Felicia Phillips

  • Psychiatric/Mental Health Nurse Practitioner
  • Middleburg Heights, OH
National Provider Identifier
1205612249
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0034830 Issued in OH
Practice address
18697 Bagley Rd
Middleburg Heights, OH 44130-3417
Phone
(440) 816-8000
NPI assigned
Sep 6, 2023
Last updated
Sep 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0034830 OH Primary

Addresses

Primary practice location

18697 Bagley Rd
Middleburg Heights, OH 44130-3417

Mailing address

5199 Crooked Creek Dr
Wooster, OH 44691-1023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231111000589 OH Practitioner - Nurse Practitioner 7214384338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

18697 Bagley Rd
Cleveland, OH 44130-3417
Phone (440) 816-6051

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.06 of 100Reported as group
Quality
63.56
Promoting interoperability
100
Improvement activities
40
Cost
73.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0034830OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest General Medical Group Inc CurrentSince Oct 31, 2023 Accepting new patients
Southwest General Medical Group Inc CurrentSince Oct 31, 2023 Accepting new patients

Locations

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

7255 Old Oak Blvd
Ste C202
Middleburg Heights, OH 44130
Phone (440) 816-5390

7265 Old Oak Blvd
Middleburg Heights, OH 44130
Phone (440) 816-5790

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1205612249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5199 CROOKED CREEK DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446911023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18697 BAGLEY RD",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303417",
            "telephone_number": "440-816-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "FELICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0034830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg Heights, OH

Sources for this page

Verify at the official NPI Registry.