Active NPI
Carol Jean Phillips
- Social Worker
- Madison, WI
National Provider Identifier
1497243687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 3440-120
- Practice address
- 1320 Mendota St Ste 120
Madison, WI 53714-1060 - Phone
- (608) 280-2700
- NPI assigned
- Apr 24, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 3440-120 | WI | Primary |
Addresses
Primary practice location
1320 Mendota St Ste 120
Madison, WI 53714-1060
Mailing address
25 Kessel CT Ste 105
Madison, WI 53711-6227
Phone (608) 280-2700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3440-120 | WI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524528000000",
"number": "1497243687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 KESSEL CT STE 105",
"city": "MADISON",
"state": "WI",
"postal_code": "537116227",
"telephone_number": "608-280-2700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 MENDOTA ST STE 120",
"city": "MADISON",
"state": "WI",
"postal_code": "537141060",
"telephone_number": "608-280-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "CAROL",
"middle_name": "JEAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-04-24",
"last_updated": "2018-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WI",
"license": "3440-120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.