Individual provider Active NPI

Tammie Jean Phillips, NP-C

  • Family Nurse Practitioner
  • Shelbyville, IN
National Provider Identifier
1366114837
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71012143A Issued in IN
Practice address
2451 Intelliplex Dr
Suite 260
Shelbyville, IN 46176-8580
Phone
(317) 398-0121
Fax
(317) 398-0538
NPI assigned
Oct 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71012143A IN Primary

Addresses

Primary practice location

2451 Intelliplex Dr
Suite 260
Shelbyville, IN 46176-8580

Mailing address

30 W Rampart St Ste 200
Shelbyville, IN 46176-8846
Phone (317) 421-2012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220121001152 IN Practitioner - Nurse Practitioner 0648662791 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71012143AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital CurrentSince Jan 19, 2022 Accepting new patients
Major Hospital CurrentSince Jan 19, 2022 Accepting new patients
Major Multispecialty Associates CurrentSince Feb 23, 2022 Accepting new patients
Major Multispecialty Associates CurrentSince Feb 23, 2022 Accepting new patients
X-Ray Physicians of Shelbyville PC Current Accepting new patients

Locations

2451 Intelliplex Dr
Shelbyville, IN 46176
Phone (317) 392-3211

30 W Rampart St
Ste 250
Shelbyville, IN 46176
Phone (317) 398-7337

30 W Rampart St
Ste 200
Shelbyville, IN 46176
Phone (317) 398-0121

2451 Intelliplex Dr
Ste 260
Shelbyville, IN 46176
Phone (317) 398-0121

2451 Intelliplex Dr
#210
Shelbyville, IN 46176
Phone (317) 421-1914

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1366114837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W RAMPART ST STE 200",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768846",
            "telephone_number": "317-421-2012",
            "fax_number": "317-398-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 INTELLIPLEX DR",
            "address_2": "SUITE 260",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768580",
            "telephone_number": "317-398-0121",
            "fax_number": "317-398-0538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "TAMMIE",
        "middle_name": "JEAN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-01",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71012143A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, IN

Sources for this page

Verify at the official NPI Registry.