Stacey Phipps

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

32001430A Issued in IN

Practice address

1950 Ridgedale Rd
South Bend, IN 46614-2243

Phone

(574) 291-6722

NPI assigned

Oct 10, 2011

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318204800000",
    "number": "1265716146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2612 SOUTHRIDGE DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466141536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 RIDGEDALE RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142243",
            "telephone_number": "574-291-6722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHIPPS",
        "first_name": "STACEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-10",
        "last_updated": "2011-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IN",
            "license": "32001430A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Pfeiffer, D.O.
• Jane P. Philips, RN, MS, OCN, CLT
• Ashley Jordyn Phillips
• Joann Lynn Phillips, M.S.W., L.S.W.
• Katelind Scarlett Phillips, CRNA
• Physical Medicine & Rehabilitation Specialists PC
• Physician Management Services of Indiana II, LLC
• Physicians Holistic Health Alliance, LLC
• Ludmila Pichugena-Emerson, NP-C
• Abigail Piechnik

• Nursing Facility/Intermediate Care Facility in South Bend, IN
• Providers in South Bend, IN by specialty
• Nursing Facility/Intermediate Care Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; 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.