Keri Nicole Phares, MA

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1167 Issued in WV

Practice address

101 S Eisenhower Dr
Beckley, WV 25801-4929

Phone

(304) 256-7100

NPI assigned

Oct 9, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• FMRS Health Systems Inc

  • Community/Behavioral Health Agency
  • Beckley, WV
  • NPI 1881733616
  Medicare reassignment NPD

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

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507507200000",
    "number": "1477063105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S EISENHOWER DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014929",
            "telephone_number": "304-256-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S EISENHOWER DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014929",
            "telephone_number": "304-256-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHARES",
        "first_name": "KERI",
        "middle_name": "NICOLE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-09",
        "last_updated": "2017-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WV",
            "license": "1167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Pettry
• Shawna Renee Pettry
• Sheina Renea Pettry
• Loan Pham
• Christina L. Phares, FNP-BC
• Alyssa N Phillips
• Brianna Phillips
• Grace Bigelow Phillips
• Jonathan Phillips
• Makayla Phillips

• Psychologist in Beckley, WV
• Providers in Beckley, WV by specialty
• Psychologist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.