Individual provider Active NPI

Jason Scott Phillips, DC

  • Chiropractor
  • Red Oak, TX
National Provider Identifier
1407376569
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
13500 Issued in TX
Practice address
307 E Ovilla Rd Ste 100
Red Oak, TX 75154-3896
Phone
(972) 576-5501
Fax
(972) 576-5654
NPI assigned
Jun 20, 2017
Last updated
Sep 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 13500 TX Primary

Addresses

Primary practice location

307 E Ovilla Rd Ste 100
Red Oak, TX 75154-3896

Mailing address

839 Red Oak Creek Dr
Ovilla, TX 75154-3600
Phone (972) 839-0706

Other practice location 1

839 Red Oak Creek Dr
Ovilla, TX 75154-3600
Phone (972) 839-0706

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13500TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Red Oak Physical Medicine Clinic PLLC Chiropractor CurrentSince Sep 13, 2020 Accepting new patients

Locations

307 E Ovilla Rd
Ste 100
Red Oak, TX 75154
Phone (972) 576-5501

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1407376569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 RED OAK CREEK DR",
            "city": "OVILLA",
            "state": "TX",
            "postal_code": "751543600",
            "telephone_number": "972-839-0706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 E OVILLA RD STE 100",
            "city": "RED OAK",
            "state": "TX",
            "postal_code": "751543896",
            "telephone_number": "972-576-5501",
            "fax_number": "972-576-5654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "839 Red Oak Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Ovilla",
            "state": "TX",
            "postal_code": "751543600",
            "country_code": "US",
            "telephone_number": "972-839-0706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JASON",
        "middle_name": "SCOTT",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-20",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "13500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Oak, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.