Individual provider Active NPI

Bobby Phillips

  • Peer Specialist
  • Desert Hot Springs, CA
National Provider Identifier
1548635535
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
66651 San Rafael Rd
Desert Hot Springs, CA 92240-2631
Phone
(760) 894-8481
NPI assigned
Dec 2, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

66651 San Rafael Rd
Desert Hot Springs, CA 92240-2631

Mailing address

66651 San Rafael Rd
Desert Hot Springs, CA 92240-2631
Phone (760) 894-8481

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

NPI Registry JSON

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449014400000",
    "number": "1548635535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66651 SAN RAFAEL RD",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922402631",
            "telephone_number": "760-894-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66651 SAN RAFAEL RD",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922402631",
            "telephone_number": "760-894-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "BOBBY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-02",
        "last_updated": "2015-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desert Hot Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; 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.