Active NPI
Ryan Phillips
- Optometrist
- Kermit, TX
National Provider Identifier
1508218686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 8937
- Practice address
- 103 S East Ave
Kermit, TX 79745-3606 - Phone
- (432) 586-3435
- NPI assigned
- Jul 12, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Optometrist | 152W00000X | 8937 | TX | Primary |
Addresses
Primary practice location
103 S East Ave
Kermit, TX 79745-3606
Mailing address
6519 Los Conchos LN
Midland, TX 79707-9616
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191016002085 | TX | Practitioner - Optometry | 4789915166 | Reassigns benefits to 3 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 2016
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Odessa Vision Center, PLLCMidland Vision Health Specialties PLLC
Practice addresses (Care Compare)
4015 Penbrook St
Odessa, TX 79762-5917
Phone (432) 362-3133
4109 N Midland Dr
Midland, TX 79707-3500
Phone (432) 694-5259
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midland Vision Health Specialties PLLC | Optometrist | Current | Accepting new patients |
| Odessa Vision Center PLLC | Optometrist | Current | Accepting new patients |
| Wallace L Phillips | Optometrist | Past | Accepting new patients |
Locations
4109 N Midland Dr
Midland, TX 79707
Phone (432) 694-5259
4015 Penbrook St
Odessa, TX 79762
Phone (432) 361-3133
Organizations & group practices 4
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.
-
- Corneal and Contact Management Optometrist
- Midland, TX
- NPI 1396961959
Optometrist, TX
-
- Optometrist
- Odessa, TX
- NPI 1578747275
-
- Optometrist
- Kermit, TX
- NPI 1003040452
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550275200000",
"number": "1508218686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6519 LOS CONCHOS LN",
"city": "MIDLAND",
"state": "TX",
"postal_code": "797079616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 S EAST AVE",
"city": "KERMIT",
"state": "TX",
"postal_code": "797453606",
"telephone_number": "432-586-3435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "RYAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-07-12",
"last_updated": "2019-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "8937",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kermit, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.