John Mark Phillips, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

538019 Issued in CA

Practice address

1100 Kansas Ave
Suite a
Modesto, CA 95351-1596

Phone

(209) 558-7475

Fax

(209) 558-4042

NPI assigned

Nov 8, 2007

Last updated

Nov 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1407036361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 KANSAS AVE",
            "address_2": "SUITE A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953511596",
            "telephone_number": "209-558-7475",
            "fax_number": "209-558-4042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 KANSAS AVE",
            "address_2": "SUITE A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953511596",
            "telephone_number": "209-558-7475",
            "fax_number": "209-558-4042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JOHN",
        "middle_name": "MARK",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-08",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "538019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phi Health, LLC (PHI Air Medical)
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• Phillip Ha Dental Corporation (Rise Orthodontics)
• Erendira Ines Phillips
• Khyla LJ Phillips
• Linda Sue Phillips, PA-C
• Shawna Phillips, SAC
• Gary W Phipps
• Amanda Phitsamay

• Psychiatric/Mental Health Registered Nurse in Modesto, CA
• Providers in Modesto, CA by specialty
• Psychiatric/Mental Health Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; 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.