John William Phillips, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

21014 Issued in IA

Practice address

1223 S Gear Ave
Ste 202
West Burlington, IA 52655-1685

Phone

(319) 754-6541

Fax

(319) 754-6544

NPI assigned

Mar 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Southeast Iowa Regional Medical Center, Inc.

  • Community Based Hospice Care Agency
  • West Burlington, IA
  • NPI 1053315002
  NPD (past)
• Southeast Iowa Regional Medical Center, Inc.

  • General Practice Physician
  • West Burlington, IA
  • NPI 1164433884
  NPD (past)

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1497723266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 S GEAR AVE",
            "address_2": "STE 202",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551685",
            "telephone_number": "319-754-6541",
            "fax_number": "319-754-6544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 S GEAR AVE",
            "address_2": "STE 202",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526551685",
            "telephone_number": "319-754-6541",
            "fax_number": "319-754-6544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "21014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0150797",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "020013502",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel J. Peasley, D.O.
• Melanie Kolbe Perkins, LISW
• Douglas W Peters, M.D.
• Bailey Peterson, LMSW
• Mary Anne Pfeifer
• Susan Kay Pickford, AUD, CCC-A
• Nicholas Christ Pothitakis, DDS
• Sara Lynn Ragar, DPT
• Viren Mawoj Kumar Raheja, MBBS
• John J Rashid, MD

• Surgery Physician in West Burlington, IA
• Providers in West Burlington, IA by specialty
• Surgery Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.