Individual provider Active NPI

Phyllis Dale Waring, MD

  • Pediatrics Physician
  • Slidell, LA
National Provider Identifier
1356494868
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
017996 Issued in LA
Practice address
204 Rue Jonathan
Slidell, LA 70461-5438
Phone
(985) 847-0689
NPI assigned
Jan 19, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 017996 LA Primary

Addresses

Primary practice location

204 Rue Jonathan
Slidell, LA 70461-5438

Mailing address

204 Rue Jonathan
Slidell, LA 70461-5438
Phone (985) 847-0689

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
017996LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's International L.L.C. Pediatrics Past Accepting new patients
Slidell Memorial Hospital Past Accepting new patients
Gulf Coast Rheumatology PastSince Jul 14, 2011 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GDBCBD

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356494868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 RUE JONATHAN",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704615438",
            "telephone_number": "985-847-0689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 RUE JONATHAN",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704615438",
            "telephone_number": "985-847-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARING",
        "first_name": "PHYLLIS",
        "middle_name": "DALE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "017996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.