NPIMap

Organization Active NPI

Phillips Foot Clinic

  • Podiatrist
  • Detroit, MI
National Provider Identifier
1295123180
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901001422 Issued in MI
Legal business name
PHILLIPS FOOT CLINIC
Doing business as
PHILLIPS FOOT CLINIC
Practice address
5575 Conner St
Suite 203
Detroit, MI 48213-6400
Phone
(313) 499-8307
NPI assigned
Dec 31, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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

Authorized official

Name
Dr. Jacqueline Phillips, DPM
Title
President
Phone
(313) 499-8307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 5901001422 MI Primary

Addresses

Primary practice location

5575 Conner St
Suite 203
Detroit, MI 48213-6400

Mailing address

5575 Conner St
Suite 203
Detroit, MI 48213-6400
Phone (313) 499-8307

Other identifiers 1

IdentifierTypeStateIssuer
1821027756MedicaidMI

Other names 1

  • PHILLIPS FOOT CLINIC Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1419984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424217600000",
    "number": "1295123180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5575 CONNER ST",
            "address_2": "SUITE 203",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482136400",
            "telephone_number": "313-499-8307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 CONNER ST",
            "address_2": "SUITE 203",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482136400",
            "telephone_number": "313-499-8307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIPS FOOT CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-31",
        "last_updated": "2015-02-18",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-499-8307",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901001422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821027756",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHILLIPS FOOT CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; 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.