Active NPI
Madison Taylor Phillips, MSW
- General Practice Physician
- Ehrenberg, AZ
National Provider Identifier
1366080475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 91820
- Practice address
- 15741 Bering St
Ehrenberg, AZ 85334-0010 - Phone
- (619) 857-6897
- NPI assigned
- Dec 19, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 91820 | CA | Primary |
Addresses
Primary practice location
15741 Bering St
Ehrenberg, AZ 85334-0010
Mailing address
PO Box 82
Ehrenberg, AZ 85334-0082
Phone (619) 857-6897
Other names 1
- Madison Phillips
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 91820 | CA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576713600000",
"number": "1366080475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 82",
"city": "EHRENBERG",
"state": "AZ",
"postal_code": "853340082",
"telephone_number": "619-857-6897"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15741 BERING ST",
"city": "EHRENBERG",
"state": "AZ",
"postal_code": "853340010",
"telephone_number": "619-857-6897"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "MADISON",
"middle_name": "TAYLOR",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-19",
"last_updated": "2019-12-19",
"certification_date": "2019-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "91820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MADISON",
"last_name": "PHILLIPS",
"credential": "MSW",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Ehrenberg, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.