Individual provider Active NPI

Marisa A Phillipps, RN

  • Registered Nurse
  • High Point, NC
National Provider Identifier
1235964651
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
196721 Issued in NC
Practice address
4050 Piedmont Pkwy
High Point, NC 27265-9458
Phone
(336) 289-8648
NPI assigned
Sep 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 196721 NC Primary

Addresses

Primary practice location

4050 Piedmont Pkwy
High Point, NC 27265-9458

Mailing address

4050 Piedmont Pkwy
High Point, NC 27265-9458
Phone (336) 289-8648

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
196721NCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Active Health Management, Inc. CurrentSince Jun 23, 2025 Accepting new patients

Locations

4050 Piedmont Pkwy
High Point, NC 27265
Phone (336) 289-8648

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1725494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1235964651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 PIEDMONT PKWY",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659458",
            "telephone_number": "336-289-8648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 PIEDMONT PKWY",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659458",
            "telephone_number": "336-289-8648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPPS",
        "first_name": "MARISA",
        "middle_name": "A",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-05",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "196721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

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