NPIMap

Organization Active NPI

Phillips Healthcare Group, PC

  • Internal Medicine Physician
  • Talbott, TN
National Provider Identifier
1467846253
Registry record updated Mar 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD024822 Issued in TN
Legal business name
PHILLIPS HEALTHCARE GROUP, PC
Practice address
6890 W.a.J. Hwy.
Talbott, TN 37877
Phone
(423) 839-2120
Fax
(423) 839-2125
NPI assigned
Mar 19, 2015
Last updated
Mar 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2015

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

Authorized official

Name
Mr. Floyd Edward Phillips Jr., M.D.NPI 1942297916
Title
Owner
Phone
(423) 273-0741

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD024822 TN Primary
Pediatrics Physician 208000000X MD024822 TN

Addresses

Primary practice location

6890 W.a.J. Hwy.
Talbott, TN 37877

Mailing address

PO Box 879
Talbott, TN 37877-0879
Phone (423) 839-2120

Other identifiers 3

IdentifierTypeStateIssuer
1528003886OtherTNNPI NUMBER
1942297916OtherTNNPI NUMBER
1396184222OtherTNNPI NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150713001003 TN Part B Supplier - Clinic/Group Practice 5193037679 Receives reassigned benefits from 12 practitioners
Practice locations: Talbott, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2093093Phillips Healthcare Group6890 W a J Hwy, Talbott, TN 37877Certificate of waiverMar 19, 2027

National Provider Directory

National Provider Directory

Locations

6890 W Andrew Johnson Hwy
Talbott, TN 37877
Phone (423) 839-2120

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426723200000",
    "number": "1467846253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 879",
            "city": "TALBOTT",
            "state": "TN",
            "postal_code": "378770879",
            "telephone_number": "423-839-2120",
            "fax_number": "423-839-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6890 W.A.J. HWY.",
            "city": "TALBOTT",
            "state": "TN",
            "postal_code": "37877",
            "telephone_number": "423-839-2120",
            "fax_number": "423-839-2125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIPS HEALTHCARE GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-19",
        "last_updated": "2015-03-19",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "FLOYD",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-273-0741",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD024822",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD024822",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1528003886",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1942297916",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1396184222",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Talbott, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.