Individual provider Active NPI

Tennille L Warren-Phillips, PSYD

  • Clinical Psychologist
  • San Antonio, TX
National Provider Identifier
1275296675
Registry record updated Oct 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
37697 Issued in TX
Practice address
7272 Wurzbach Rd Ste 706
San Antonio, TX 78240-4803
Phone
(210) 615-3483
NPI assigned
Oct 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 37697 TX Primary

Addresses

Primary practice location

7272 Wurzbach Rd Ste 706
San Antonio, TX 78240-4803

Mailing address

1200 Texas St
Houston, TX 77002-3505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2024 through Apr 1, 2028

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.17 of 100Reported as group
Quality
83.48
Improvement activities
40
Cost
67.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37697TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697846400000",
    "number": "1275296675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 TEXAS ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770023505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7272 WURZBACH RD STE 706",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782404803",
            "telephone_number": "210-615-3483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN-PHILLIPS",
        "first_name": "TENNILLE",
        "middle_name": "L",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-21",
        "last_updated": "2023-10-21",
        "certification_date": "2023-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "37697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.