Michael Jerome Phillips, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

38408 Issued in NC

Practice address

3110 Wellons Blvd
Suite C
New Bern, NC 28562-5247

Phone

(252) 638-2515

Fax

(252) 638-8538

NPI assigned

Apr 6, 2006

Last updated

May 16, 2014By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Triad ENT PA

  • Specialist
  • Lexington, NC
  • NPI 1447345616

  Otolaryngology

  NPD (past) Authorized official

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400198400000",
    "number": "1417919044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602522",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602522",
            "telephone_number": "252-638-2515",
            "fax_number": "252-638-8538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 WELLONS BLVD",
            "address_2": "SUITE C",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625247",
            "telephone_number": "252-638-2515",
            "fax_number": "252-638-8538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MICHAEL",
        "middle_name": "JEROME",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2014-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": "38408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8967661",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Dee Phasukkan, BCBA
• Shelly Phillips-Dean
• John Michael Phillips, PHARMD
• Keely Phillips
• Michael Jay Phillips, MD
• Picc & Vascular Access Professionals PLLC
• Lisa Pickering
• Matthew Arden Pierce, M.D.
• Melissa Ann Pierce
• Amy Elizabeth Pietri, M.D.

• Otolaryngology Physician in New Bern, NC
• Providers in New Bern, NC by specialty
• Otolaryngology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2014; 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.