Individual provider Active NPI

Renee Phillips

  • Licensed Practical Nurse
  • Toledo, OH
National Provider Identifier
1588024541
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
101973 Issued in OH
Practice address
6605 W Central Ave
Toledo, OH 43617-1000
Phone
(419) 841-7701
Fax
(419) 841-8600
NPI assigned
Mar 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 101973 OH Primary

Addresses

Primary practice location

6605 W Central Ave
Toledo, OH 43617-1000

Mailing address

2155 McIntosh Dr
Holland, OH 43528-7932
Phone (410) 260-5160

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
101973OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1588024541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 MCINTOSH DR",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435287932",
            "telephone_number": "410-260-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6605 W CENTRAL AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171000",
            "telephone_number": "419-841-7701",
            "fax_number": "419-841-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-03",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "101973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.