Phoenix Enterprise

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PHOENIX ENTERPRISE

Practice address

3191 Beaumont Centre Cir Ste 150
Lexington, KY 40513-1830

Phone

(859) 900-2668

NPI assigned

Aug 4, 2020

Organization subpart

No

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

Authorized official

Name

Steve Netherton

Title

Official

Phone

(502) 551-9988

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Phoenix Diagnostics Doing business as

Locations

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596499200000",
    "number": "1326658477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W VINE ST STE 1408",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405071814",
            "telephone_number": "859-900-2668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3191 BEAUMONT CENTRE CIR STE 150",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131830",
            "telephone_number": "859-900-2668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX ENTERPRISE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-04",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A",
        "authorized_official_last_name": "NETHERTON",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "OFFICIAL",
        "authorized_official_telephone_number": "502-551-9988"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTCKY STATE LICENSE",
            "identifier": "200414",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "18D2188408",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vanessa Phillips, LCSW
• Katherine Gaddy Philpot
• Amanda Phipps
• Gabrielle Phipps
• Paul Steven Phipps, CRNA - ARNP
• Phoenix Health Associates PLLC
• Phoenix Recovery LLC
• Lauren Marie Phoenix, CRNA
• Deoborah Photos, DPM
• Melanie Sarinthone Phounsavath, PA

• All providers in Lexington, KY
• Clinical Medical Laboratory in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; 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.