Edward K. Phillips, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

09170 Issued in MS

Practice address

1010 Lakeland Square Ext Ste B
Flowood, MS 39232-7607

Phone

(601) 936-0890

Fax

(601) 936-0891

NPI assigned

Aug 16, 2006

Last updated

Apr 27, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Mississippi Baptist Medical Center, Inc.

  dba MS Bapitst Medical Center Geri-Psych Unit

  • Psychiatric Hospital Unit
  • Jackson, MS
  • NPI 1417984360
  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1366555328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 VALLEY STREAM PKWY STE 100",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193551407",
            "telephone_number": "610-644-8900",
            "fax_number": "484-924-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 LAKELAND SQUARE EXT STE B",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392327607",
            "telephone_number": "601-936-0890",
            "fax_number": "601-936-0891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "EDWARD",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MS",
            "license": "9170",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "09170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00115950",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elliott Pettus
• Pharmakan, Inc (professional pharmacy services of jackson)
• Pharmakeus Inc (Martys Pharmacy and Compounding Center)
• Francis M Phillippi IV, MD
• Danielle Phillips, FNP
• Nicholas Phillips
• Physician Hospice Care LLC
• Physiolete Therapy and Performance LLC
• Piece of Mind Medical LLC
• Alana Piersanti, MD

• Diagnostic Radiology Physician in Flowood, MS
• Providers in Flowood, MS by specialty
• Diagnostic Radiology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; 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.