Phoenix Health Center, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

N1355 Issued in TX

Legal business name

PHOENIX HEALTH CENTER, PLLC

Practice address

1114 W Bow St
Tyler, TX 75702-5137

Phone

(903) 595-5595

Fax

(903) 595-5985

NPI assigned

Jan 8, 2014

Organization subpart

No

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

Authorized official

Name

Dorothy Louise Jackson, MDNPI 1922071042

Title

Sole Owner

Phone

(903) 595-5595

Specialties & licenses 1

Addresses

Other names 1

• Phoenix Health Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/27019/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dorothy Louise Jackson, MD

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1922071042
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1389139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403568000000",
    "number": "1295157337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 W BOW ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757025137",
            "telephone_number": "903-595-5595",
            "fax_number": "903-595-5985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 W BOW ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757025137",
            "telephone_number": "903-595-5595",
            "fax_number": "903-595-5985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HEALTH CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-08",
        "last_updated": "2014-06-24",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "903-595-5595",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N1355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Scott Alan Phillips, PA-C
• Wendell S Phillips, MD
• William F Phillips, MD
• Andrew Phillpott, DO
• Emily Ann Phillps
• Jason Alexander Phung, MD
• Physicians Caring for People
• Jennifer Ann Piazza, M.S.
• Tonya Deeann Pickens
• Merwyn Glenn Pickle, DDS

• Family Medicine Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.