Traci Marlena Phillips, BSN,RN,MSN,FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

66503 Issued in WV

Practice address

723 9TH Ave
Huntington, WV 25701-2718

Phone

(045) 290-6453

Fax

(304) 529-3026

NPI assigned

Nov 10, 2009

Sex

Female

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 3

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Health Systems, IncGroup PAC ID 9931017969, shared by 41 NPIs, 110 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor on Science - Nursing, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tphillips20458@valleyhealthsystems.direct-ci.com

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.

• Valley Health Systems Inc

  • Federally Qualified Health Center (FQHC)
  • Huntington, WV
  • NPI 1164730271
  Medicare reassignment NPD
• Valley Health Systems Inc

  • Federally Qualified Health Center (FQHC)
  • Wayne, WV
  • NPI 1194790022
  Medicare reassignment NPD
• Valley Health Systems Inc

  • Federally Qualified Health Center (FQHC)
  • Apple Grove, WV
  • NPI 1568232312
  Medicare reassignment NPD
• Valley Health Systems Inc

  • Federally Qualified Health Center (FQHC)
  • Huntington, WV
  • NPI 1659346757
  Medicare reassignment NPD
• Valley Health Systems Inc

  • Federally Qualified Health Center (FQHC)
  • Huntington, WV
  • NPI 1720333461

  Nurse Practitioner

  Medicare reassignment NPD
• Valley Health Systems Inc

  • Federally Qualified Health Center (FQHC)
  • Huntington, WV
  • NPI 1760458350
  Medicare reassignment NPD
• Valley Health Systems Inc

  • Federally Qualified Health Center (FQHC)
  • Huntington, WV
  • NPI 1902962368

  Nurse Practitioner

  Medicare reassignment NPD
• Valley Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Harts, WV
  • NPI 1154697431
  Medicare reassignment NPD
• Valley Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Scott Depot, WV
  • NPI 1700446929
  Medicare reassignment NPD
• Valley Health Systems Inc

  • Clinical Medical Laboratory
  • Huntington, WV
  • NPI 1023083854
  NPD
• Valley Health Systems Inc

  • Obstetrics & Gynecology Physician
  • Huntington, WV
  • NPI 1184699415
  NPD
• Valley Health Systems Inc

  • Federally Qualified Health Center (FQHC)
  • Hurricane, WV
  • NPI 1225154206
  NPD

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

{
    "created_epoch": "1257811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1578890752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1680",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257171680",
            "telephone_number": "304-528-6445",
            "fax_number": "304-528-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 9TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257012718",
            "telephone_number": "045-290-6453",
            "fax_number": "304-529-3026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "85 Donohoe Dr",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257058887",
            "country_code": "US",
            "telephone_number": "304-399-3310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "TRACI",
        "middle_name": "MARLENA",
        "credential": "BSN,RN,MSN,FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-10",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "66503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100116110",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3040355",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810017383",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mariah Phillips
• Ruby Louise Phillips
• Shellie Nicole Phillips
• Tenikka Phillips, LPC
• Teresa June Phillips
• William Hairston Phillips
• Mackenzie G Phipps, PHARMD
• Christopher Picklesimer
• Elizabeth Ann Picklesimer, LPC
• Christina D Pickron

• Nurse Practitioner in Huntington, WV
• Providers in Huntington, WV by specialty
• Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.

Verify at the official NPI Registry.