NPIMap

Individual provider Active NPI

Annie R. Phillips, PSY.D.

  • Psychologist
  • Alpharetta, GA
National Provider Identifier
1427306646
Registry record updated Aug 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY003556 Issued in GA
Practice address
5755 Northpoint Pkwy
Suite 256
Alpharetta, GA 30022-1142
Phone
(770) 667-3877
Fax
(770) 667-3879
NPI assigned
Aug 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY003556 GA Primary

Addresses

Primary practice location

5755 Northpoint Pkwy
Suite 256
Alpharetta, GA 30022-1142

Mailing address

PO Box 250
Alpharetta, GA 30009-0250
Phone (770) 667-3877

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
PSY003556GAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Psychological Services, Inc. Past Accepting new patients
Northside Psychological Services, Inc. Past Accepting new patients
Outpatient Behavioral Health, LLC PastSince Aug 23, 2020 Accepting new patients

Organizations & group practices 3

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": "1345420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345420800000",
    "number": "1427306646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300090250",
            "telephone_number": "770-667-3877",
            "fax_number": "770-667-3879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5755 NORTHPOINT PKWY",
            "address_2": "SUITE 256",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300221142",
            "telephone_number": "770-667-3877",
            "fax_number": "770-667-3879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "ANNIE",
        "middle_name": "R.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-20",
        "last_updated": "2012-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY003556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; 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.