Active NPI
Minta Elizabeth Phillips, MD
- Diagnostic Radiology Physician
- Greensboro, NC
National Provider Identifier
1578547766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 34128
- Practice address
- 1317 N Elm St
Suite 1B
Greensboro, NC 27401-1023 - Phone
- (336) 274-9617
- Fax
- (336) 482-2177
- NPI assigned
- Dec 1, 2005
- Last updated
- Aug 10, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 34128 | NC | Primary |
Addresses
Primary practice location
1317 N Elm St
Suite 1B
Greensboro, NC 27401-1023
Mailing address
1317 N Elm Street
Suite 1B
Greensboro, NC 27401-1023
Phone (336) 274-9617
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1600768 | Other | NC | UNITED HEALTHCARE |
| 73484 | Other | NC | MEDCOST |
| 8967664 | Medicaid | NC | |
| 300085688 | Other | NC | RAILROAD MEDICARE |
| 24728 | Other | NC | PARTNERS |
| 67664 | Other | NC | BLUE CROSS BLUE SHIELD |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344556800000",
"number": "1578547766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1317 N ELM STREET",
"address_2": "SUITE 1B",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274011023",
"telephone_number": "336-274-9617",
"fax_number": "336-482-2177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1317 N ELM ST",
"address_2": "SUITE 1B",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274011023",
"telephone_number": "336-274-9617",
"fax_number": "336-482-2177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "MINTA",
"middle_name": "ELIZABETH",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-12-01",
"last_updated": "2012-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NC",
"license": "34128",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "1600768",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "73484",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8967664",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "300085688",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS",
"identifier": "24728",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "67664",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.