NPIMap

Individual provider Active NPI

John H Phillips, M.D.

  • Internal Medicine Physician
  • Ontario, OR
National Provider Identifier
1477567485
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD11306 Issued in OR
Practice address
485 Stanton Blvd
Ontario, OR 97914-8435
Phone
(208) 739-0087
Fax
(541) 889-4232
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD11306 OR Primary

Addresses

Primary practice location

485 Stanton Blvd
Ontario, OR 97914-8435

Mailing address

485 Stanton Blvd
Ontario, OR 97914-8435
Phone (208) 739-0087

Other identifiers 2

IdentifierTypeStateIssuer
00543-9MedicaidOR
003393200MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050201000948 OR Practitioner - Internal Medicine 4587615158 Practice locations: Baker City, OR

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Arizona College of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Malheur Memorial Health CenterGroup PAC ID 3678545993, 3 clinicians

Practice addresses (Care Compare)

410 Main St
Nyssa, OR 97913-3973
Phone (541) 372-2211

Hospital & facility affiliations

  • Enhabit Home Health of Western Idaho Home health agency, Fruitland, ID, CCN 137113
  • Saint Alphonsus Medical Center Ontario Hospital, Ontario, OR, CCN 380052
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • Pioneer Nursing Home Nursing home, Vale, OR, CCN 385273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD11306ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Medical Center- Ontario Inc Internal Medicine Past Accepting new patients
Malheur Memorial Health Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: malheurmemorial.johnphillips@136482.advancedmd-direct.com
  • Direct secure messaging: jphillips@2418.securemail.prognocis.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Pioneer Place Nursing and RehabilitationVale, OR, CCN 385273 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2016
Jan 1, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1477567485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 STANTON BLVD",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979148435",
            "telephone_number": "208-739-0087",
            "fax_number": "541-889-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 STANTON BLVD",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979148435",
            "telephone_number": "208-739-0087",
            "fax_number": "541-889-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JOHN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD11306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00543-9",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003393200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, OR

Sources for this page

Verify at the official NPI Registry.