Individual provider Active NPI

Tess Emma Phillips, RD, RDN, IBCLC

  • Lactation Consultant (Non-RN)
  • Indianapolis, IN
National Provider Identifier
1538043526
Registry record updated Aug 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
L-319389 Issued in IN
Practice address
3908 Meadows Dr
Indianapolis, IN 46205-3114
Phone
(361) 774-4974
NPI assigned
Aug 2, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X 86104229 IN
Health & Wellness Coach 171400000X 86104229 IN
Lactation Consultant (Non-RN) 174N00000X L-319389 IN Primary

Addresses

Primary practice location

3908 Meadows Dr
Indianapolis, IN 46205-3114

Mailing address

9031 Harrison Run CT
Indianapolis, IN 46256-1890
Phone (361) 774-4974

Other practice location 1

9031 Harrison Run Ct
Indianapolis, IN 46256-1890
Phone (361) 774-4974

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

LicenseStateTypeSpecialty
86104229INMDPediatric Nutrition Registered Dietitian
L-319389INMDLactation Consultant (Non-RN)

NPI Registry JSON

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

{
    "created_epoch": "1754092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754092800000",
    "number": "1538043526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9031 HARRISON RUN CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561890",
            "telephone_number": "361-774-4974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3908 MEADOWS DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462053114",
            "telephone_number": "361-774-4974"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9031 Harrison Run Ct",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462561890",
            "country_code": "US",
            "telephone_number": "361-774-4974",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "TESS",
        "middle_name": "EMMA",
        "credential": "RD, RDN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-02",
        "last_updated": "2025-08-02",
        "certification_date": "2025-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "IN",
            "license": "86104229",
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "IN",
            "license": "86104229",
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "IN",
            "license": "L-319389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2025; 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.