Individual provider Active NPI

Stephen W Phillips, M.D.

  • Diagnostic Radiology Physician
  • Houston, TX
National Provider Identifier
1396722393
Registry record updated Jun 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
N1068 Issued in TX
Practice address
6550 Fannin
Sm749
Houston, TX 77030
Phone
(713) 441-7465
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 44379 MN
Diagnostic Radiology Physician 2085R0202X N1068 TX Primary

Addresses

Primary practice location

6550 Fannin
Sm749
Houston, TX 77030

Mailing address

6550 Fannin St
Sm749
Houston, TX 77030-2717
Phone (713) 441-7465

Other identifiers 3

IdentifierTypeStateIssuer
200189301MedicaidTX
031638500MedicaidMN
8BQ331OtherBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44379MNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TMH Physician Associates PLLC Past Accepting new patients
Southern Indiana Radiological Associates Inc Diagnostic Radiology Past Accepting new patients

Organizations & group practices 2

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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244592000000",
    "number": "1396722393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6550 FANNIN ST",
            "address_2": "SM749",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302717",
            "telephone_number": "713-441-7465",
            "fax_number": "713-790-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 FANNIN",
            "address_2": "SM749",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "713-441-7465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "STEPHEN",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2009-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "44379",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "N1068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200189301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031638500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8BQ331",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2009; 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.