NPIMap

Organization Active NPI

Phillips Pediatrics, LLC

Doing business as Phillips Pediatrics

  • Pediatrics Physician
  • Oxford, MS
National Provider Identifier
1487205829
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PHILLIPS PEDIATRICS, LLC
Doing business as
Phillips Pediatrics
Practice address
2682 W Oxford Loop Ste 130
Oxford, MS 38655-5441
Phone
(662) 371-1543
Fax
(662) 371-1548
NPI assigned
Sep 26, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Authorized official

Name
Dr. Catherine Durst Phillips, DONPI 1477870822
Title
Member
Phone
(662) 371-1543

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

2682 W Oxford Loop Ste 130
Oxford, MS 38655-5441

Mailing address

2682 W Oxford Loop Ste 130
Oxford, MS 38655-5441
Phone (662) 371-1543

Other identifiers 1

IdentifierTypeStateIssuer
01224088MedicaidMS

Other names 1

  • Phillips Pediatrics Doing business as

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
25D2173851Phillips Pediatrics LLC2682 W Oxford LP Ste 130, Oxford, MS 38655ComplianceJul 12, 2027

National Provider Directory

National Provider Directory

Locations

2682 West Oxford Loop
Ste 130
Oxford, MS 38655
Phone (662) 371-1543

Practitioners & affiliated clinicians

Practitioners 3

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": "1569456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581465600000",
    "number": "1487205829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2682 W OXFORD LOOP STE 130",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555441",
            "telephone_number": "662-371-1543",
            "fax_number": "662-371-1548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2682 W OXFORD LOOP STE 130",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555441",
            "telephone_number": "662-371-1543",
            "fax_number": "662-371-1548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIPS PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-26",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "DURST",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "662-371-1543",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01224088",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phillips Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Phillips Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oxford, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.