Individual provider Active NPI

Sara Boutwell Phillips, M.D.

  • Pediatrics Physician
  • Tuscaloosa, AL
National Provider Identifier
1376986059
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD35015 Issued in AL
Practice address
850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7419
Phone
(205) 348-1770
Fax
(205) 348-7988
NPI assigned
Apr 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X MD35015 AL Primary

Addresses

Primary practice location

850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7419

Mailing address

850 Peter Bryce Blvd
Tuscaloosa, AL 35401-7419
Phone (205) 348-1770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20161011001676 AL Practitioner - Pediatric Medicine 8325367063 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD35015ALMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The DCH Health Care Authority CurrentSince Oct 11, 2024 Accepting new patients
Capstone Health Services Foundation PC CurrentSince Jul 1, 2016 Accepting new patients
The DCH Healthcare Authority CurrentSince Oct 11, 2024 Accepting new patients
Capstone Health Services Foundation PC CurrentSince Jul 1, 2016 Accepting new patients
DCH Provider Services, LLC Past Accepting new patients

Locations

2700 Hospital Dr
Northport, AL 35476
Phone (205) 333-4500

809 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 333-4661

850 Peter Bryce Blvd
Tuscaloosa, AL 35401

Interoperability endpoints

  • Direct secure messaging: sara.phillips.p1@direct.umc.nextgenshare.com

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": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1376986059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 PETER BRYCE BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017419",
            "telephone_number": "205-348-1770",
            "fax_number": "205-348-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 PETER BRYCE BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017419",
            "telephone_number": "205-348-1770",
            "fax_number": "205-348-7988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "SARA",
        "middle_name": "BOUTWELL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "MD35015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.