Charles Philip, D.O.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

053621 Issued in CT

Practice address

345 N Main St FL 1
West Hartford, CT 06117-2515

Phone

(860) 547-1489

Fax

(860) 548-9105

NPI assigned

Aug 28, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Trinity Health of New England Provider Network Organization Inc

  dba Trinity Health Of New England Medical Group

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1003882812

  Cardiovascular Disease

  Medicare reassignment NPD
• Trinity Health of New England Provider Network Organization Inc

  dba Trinity Health Of New England Medical Group

  • Internal Medicine Physician
  • Waterville, ME
  • NPI 1134779531
  NPD

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424908800000",
    "number": "1255525754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 N MAIN ST FL 1",
            "address_2": "APT",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172515",
            "telephone_number": "860-547-1489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 N MAIN ST FL 1",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172515",
            "telephone_number": "860-547-1489",
            "fax_number": "860-548-9105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIP",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-28",
        "last_updated": "2015-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CT",
            "license": "053621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Elizabeth Peterman, PHD
• Matthew Paul Peverly, OT
• Pharmacyatbbsquare LLC
• Pharmacyatbbsquare LLC (Pharmacy at Blue Back)
• Frances R Phelps, RPT
• Meghan Philips, APRN
• Cruger Johnson Phillips, L.P.C.
• Doris J Phillips, MD
• Janna Marie Phillips, L.C.S.W.
• Phoenix Healing, LLC

• Cardiovascular Disease Physician in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Cardiovascular Disease Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.