Individual provider Active NPI

Joseph P Phillips, MD

  • Gastroenterology Physician
  • Hattiesburg, MS
National Provider Identifier
1366550758
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
13227 Issued in MS
Practice address
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone
(601) 268-5680
Fax
(601) 268-5778
NPI assigned
Aug 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 13227 MS Primary

Addresses

Primary practice location

415 S 28TH Ave
Hattiesburg, MS 39401-7246

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 268-5680

Other identifiers 3

IdentifierTypeStateIssuer
1031674MedicaidLA
640507572APOtherMSAMERICAN ADMIN GROUP
00116691MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jphillips2656@directpatientrecord.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080123000796 MS Practitioner - Gastroenterology 4183725500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Mississippi School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Practice addresses (Care Compare)

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy332
Upper gastrointestinal (GI) endoscopy for acid reflux226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13227MSMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hattiesburg Clinic PA CurrentSince Jul 1, 1996 Accepting new patients
Hattiesburg Clinic, PA CurrentSince Jul 1, 1996 Accepting new patients
Hattiesburg Clinic, PA Past Accepting new patients

Locations

502 Broad St
Columbia, MS 39429
Phone (601) 736-8282

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

415 S 28th Ave
Fl 5
Hattiesburg, MS 39401

Interoperability endpoints

  • Direct secure messaging: jphillips2656@directpatientrecord.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1366550758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-268-5680",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-268-5680",
            "fax_number": "601-268-5778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JOSEPH",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-27",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MS",
            "license": "13227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031674",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ADMIN GROUP",
            "identifier": "640507572AP",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00116691",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jphillips2656@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "415 S 28th Ave",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394017246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.