Active NPI
Mitzi Elaine Phillips, PTA
- Preferred Provider Organization
- Morganton, NC
National Provider Identifier
1255779161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Preferred Provider Organization
- License
- 1883
- Practice address
- 6985 Nuggett Dr
Morganton, NC 28655-7994 - Phone
- (828) 443-3185
- NPI assigned
- Jun 13, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Preferred Provider Organization | 305R00000X | 1883 | NC | Primary |
Addresses
Primary practice location
6985 Nuggett Dr
Morganton, NC 28655-7994
Mailing address
6985 Nuggett Dr
Morganton, NC 28655-7994
Phone (828) 443-3185
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1883 | Other | NC | PHYCSICAL THERAPIST ASSISTANT |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1883 | NC | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371081600000",
"number": "1255779161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6985 NUGGETT DR",
"city": "MORGANTON",
"state": "NC",
"postal_code": "286557994",
"telephone_number": "828-443-3185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6985 NUGGETT DR",
"city": "MORGANTON",
"state": "NC",
"postal_code": "286557994",
"telephone_number": "828-443-3185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "MITZI",
"middle_name": "ELAINE",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-06-13",
"last_updated": "2013-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "305R00000X",
"taxonomy_group": "",
"desc": "Preferred Provider Organization",
"state": "NC",
"license": "1883",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYCSICAL THERAPIST ASSISTANT",
"identifier": "1883",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Morganton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.