Active NPI
Paul D Phillip
- Mental Health Counselor
- Rio Rancho, NM
National Provider Identifier
1447875133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1207 Golf Course Rd NE
Suite C
Rio Rancho, NM 87124 - Phone
- (505) 994-1229
- NPI assigned
- Jun 9, 2020
- Last updated
- Jun 9, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | NM | Primary |
Addresses
Primary practice location
1207 Golf Course Rd NE
Suite C
Rio Rancho, NM 87124
Mailing address
527 Brianna Loop NE
Albuquerque, NM 87113-1479
Phone (505) 414-4029
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Sagebrush St SW
Albuquerque, NM 87105-3942
Phone (505) 869-4463
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pueblo of Isleta | Current | Accepting new patients | |
| Pueblo of Isleta | Current | Accepting new patients | |
| Pueblo of Isleta | Past | Accepting new patients |
Locations
1 Sagebrush St SW
Albuquerque, NM 87105
Phone (505) 869-4463
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Pueblo of Isleta Dental Clinic
- Public Health Dentistry
- Isleta, NM
- NPI 1225158348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591660800000",
"number": "1447875133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "527 BRIANNA LOOP NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871131479",
"telephone_number": "505-414-4029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1207 GOLF COURSE RD NE",
"address_2": "SUITE C",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "87124",
"telephone_number": "505-994-1229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIP",
"first_name": "PAUL",
"middle_name": "D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-06-09",
"last_updated": "2020-06-09",
"certification_date": "2020-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rio Rancho, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.