Active NPI
Philip W Story, SW
- Social Worker
- Beloit, WI
National Provider Identifier
1467632927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 5825-120
- Practice address
- 64 Eclipse Ctr
Beloit, WI 53511-3550 - Phone
- (608) 363-6200
- NPI assigned
- Nov 13, 2007
- Last updated
- Nov 13, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 5825-120 | WI | Primary |
Addresses
Primary practice location
64 Eclipse Ctr
Beloit, WI 53511-3550
Mailing address
64 Eclipse Ctr
Beloit, WI 53511-3550
Phone (608) 363-6200
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5825-120 | WI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194912000000",
"number": "1467632927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "64 ECLIPSE CTR",
"city": "BELOIT",
"state": "WI",
"postal_code": "535113550",
"telephone_number": "608-363-6200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "64 ECLIPSE CTR",
"city": "BELOIT",
"state": "WI",
"postal_code": "535113550",
"telephone_number": "608-363-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STORY",
"first_name": "PHILIP",
"middle_name": "W",
"credential": "SW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-13",
"last_updated": "2007-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WI",
"license": "5825-120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beloit, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.