John Caleb Phillips, UNIT MANAGER LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

2052375 Issued in KY

Practice address

100 Davco Dr
Danville, KY 40422-8477

Phone

(859) 236-5383

Fax

(859) 270-7696

NPI assigned

Jun 11, 2021

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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Trilogy Healthcare of Danville, LLC

  dba Walker's Trail Senior Living

  • Assisted Living Facility
  • Danville, KY
  • NPI 1740872803
  NPD

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1528636057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 DAVCO DR",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404228477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DAVCO DR",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404228477",
            "telephone_number": "859-236-5383",
            "fax_number": "859-270-7696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JOHN",
        "middle_name": "CALEB",
        "credential": "UNIT MANAGER LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-11",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "KY",
            "license": "2052375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASSISTED LIVING",
            "identifier": "364SL0600X",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Caleb.Phillips@walkerstrailsl.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 Davco Dr",
            "city": "Danville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "404228477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pelvicsmart Rehabilitation and Wellness, PLLC
• Kara Fricke Pendergrass, MS, RD, LD
• Peter F. Ballard, M.D., PSC
• Ashley Elizabeth Peterson, OD
• James Lee Phillips II, PT, DPT
• Phoenix Physical Therapy, PLLC
• Pioneer Vocational Industrial Services,Inc.
• Jessica Lynn Popplewell, DMD
• Mark Elliott Porter II, LPCA, TCM
• Ashley Potts, DC

• Licensed Practical Nurse in Danville, KY
• Providers in Danville, KY by specialty
• Licensed Practical Nurse in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; 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.