Susan Moore Phillips, RN

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

132697 Issued in TN

Practice address

103 Stateside Dr
Jonesborough, TN 37659-6837

Phone

(423) 753-5896

NPI assigned

Mar 26, 2010

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1269561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269561600000",
    "number": "1487978995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 STATESIDE DR",
            "city": "JONESBOROUGH",
            "state": "TN",
            "postal_code": "376596837",
            "telephone_number": "423-753-5896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 STATESIDE DR",
            "city": "JONESBOROUGH",
            "state": "TN",
            "postal_code": "376596837",
            "telephone_number": "423-753-5896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "SUSAN",
        "middle_name": "MOORE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-26",
        "last_updated": "2010-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "TN",
            "license": "132697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen J. Peacock, FNP
• John C. Pennington, M.A., CCC-SLP
• Petersen Family Chiropractic
• Howard Gale Petersen, DC
• Abigail Rae Phillips, LMSW
• Anna Lauren Pierce
• Barbara W Porteous
• Premise Health of Tennessee Medical PC
• Private Healthcare Facilities
• PT Solutions LLC

• All providers in Jonesborough, TN
• General Practice Registered Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.