Johnathan Phillips

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW13595 Issued in FL

Practice address

1834A Jaclif CT
Tallahassee, FL 32308-4400

Phone

(850) 681-6001

Fax

(850) 681-6003

NPI assigned

Feb 18, 2014

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Florida Therapy Services, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pensacola, FL
  • NPI 1407427800
  NPD

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

{
    "created_epoch": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1386068013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 GRACE AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324012756",
            "telephone_number": "850-215-6007",
            "fax_number": "850-215-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1834A JACLIF CT",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084400",
            "telephone_number": "850-681-6001",
            "fax_number": "850-681-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JOHNATHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-18",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Slanda Philistin
• Phillips Street Opco LLC
• Brandon Todd Phillips, MHSC, CAA
• Carswella Odessa Phillips, ARNP
• David Leonard Phillips
• Kadrian Phillips
• Kendra Phillips, PHARMD
• Lauren N Phillips, CRNA
• Mary Katherine Phillips, P.A.
• Michelle Phillips

• Clinical Social Worker in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.