Active NPI
Bradford G. Phillips, PA-C
- Physician Assistant
- Rumford, ME
National Provider Identifier
1275554669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA 132
- Practice address
- 431 Franklin St
Rumford, ME 04276-2100 - Phone
- (207) 369-3200
- NPI assigned
- Jul 21, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 132 | ME | Primary |
Addresses
Primary practice location
431 Franklin St
Rumford, ME 04276-2100
Mailing address
580 Curtis Hill Rd
Bryant Pond, ME 04219-6538
Phone (207) 674-3862
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 132 | ME | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1275554669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "580 CURTIS HILL RD",
"city": "BRYANT POND",
"state": "ME",
"postal_code": "042196538",
"telephone_number": "207-674-3862"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "431 FRANKLIN ST",
"city": "RUMFORD",
"state": "ME",
"postal_code": "042762100",
"telephone_number": "207-369-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "BRADFORD",
"middle_name": "G.",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ME",
"license": "PA 132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rumford, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.