John Joseph Phillips, MS-CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

005836-1 Issued in NY

Practice address

84 Nightengale Ave
Massena, NY 13662-2538

Phone

(315) 764-3700

NPI assigned

Nov 16, 2011

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Massena Central School District

  • Local Education Agency (LEA)
  • Massena, NY
  • NPI 1215094545
  NPD (past)

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1376820563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 HIGHLAND AVE",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "136621772",
            "telephone_number": "315-764-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 NIGHTENGALE AVE",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "136622538",
            "telephone_number": "315-764-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "MS-CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-16",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "005836-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara J Perez, SOCIAL WORKER
• Marisa Perry, BS
• Alexandra Pesold, FNP
• Denise Zuniga Peterson, LPN
• Phillgrey Inc
• Jennifer Lee Pike, RN
• Jamie Pirie
• Randal Joseph Place, D.D.S.
• Deborah Ellen Prashaw, RN
• Michelle R Prentice, MD

• All providers in Massena, NY
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; 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.