Fred A Phillips, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

085815 Issued in NY

Practice address

64 Hickock Rd
Greenfield Center, NY 12833-1402

Phone

(518) 584-3162

NPI assigned

Feb 14, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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

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.

• Community Care Physicians, PLLC

  • Internal Medicine Physician
  • Latham, NY
  • NPI 1922048370
  NPD (past)

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202947200000",
    "number": "1376711150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 HICKOCK RD",
            "city": "GREENFIELD CENTER",
            "state": "NY",
            "postal_code": "128331402",
            "telephone_number": "518-584-3162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 HICKOCK RD",
            "city": "GREENFIELD CENTER",
            "state": "NY",
            "postal_code": "128331402",
            "telephone_number": "518-584-3162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "FRED",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-14",
        "last_updated": "2008-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "085815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "085815",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Ann Lambert
• Eileen Lindemann, R.D.
• Aili Anais Lopez, LMHC, ATR
• Eva Miller, LMT
• Rebecca Neal, PMHNP
• Julia Marie Pratt, DDS
• Reliable Ridez LLC
• Holly R Shishik, RPH
• Lisa D Temoshok
• Beth Tooker, LMSW

• Internal Medicine Physician in Greenfield Center, NY
• Providers in Greenfield Center, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; 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.