Brian Russell Phillips, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

71013428A Issued in IN

Practice address

9250 Columbia Ave Ste 2E
Munster, IN 46321-3530

Phone

(219) 648-2400

NPI assigned

Jan 6, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, OH2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nwi Clarity ClinicGroup PAC ID 5991082976, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nwi Clarity Clinic

  • Clinical Social Worker
  • Munster, IN
  • NPI 1619412160
  Medicare reassignment Care Compare group NPD
• Aims, LLC

  • Psychiatry Physician
  • Bremen, IN
  • NPI 1376072785
  Medicare reassignment NPD
• 360Team Psychiatry LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Perrysburg, OH
  • NPI 1780267146
  Medicare reassignment NPD
• Onhealthcare LLC

  • Podiatrist
  • Indianapolis, IN
  • NPI 1952677353
  NPD (past)

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1326752221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 COLUMBIA AVE STE 2E",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463213530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 COLUMBIA AVE STE 2E",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463213530",
            "telephone_number": "219-648-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "BRIAN",
        "middle_name": "RUSSELL",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-06",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71013428A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Petrungaro Plastic Surgery, LLC
• Jason Michael Petrungaro, M.D.
• Nicole Marie Petrungaro, CRNA
• Allyson Philbin, PA-C
• Angela Bonnie Phillips, PSY.D., HSPP
• Physicians Optical Center LLC
• Physionique LLC
• Michelle Piatek
• Judith Marie Pickett, M.D.
• Taylor Pierce

• Psychiatric/Mental Health Nurse Practitioner in Munster, IN
• Providers in Munster, IN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.