Autumn Rose Phillips, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY22939 Issued in CA

Practice address

7592 Metropolitan Dr
Ste 400
San Diego, CA 92108-4428

Phone

(877) 727-5974

Fax

(877) 728-3404

NPI assigned

May 10, 2010

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Phillips Medstone a Psychological CorporationGroup PAC ID 6507099603, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Phillips Medstone a Psychological Corporation

  • Psychologist
  • San Diego, CA
  • NPI 1801222120
  Medicare reassignment Care Compare group NPD Authorized official
• Chronic Pain Associates, P.C.

  • Rehabilitation Practitioner
  • San Diego, CA
  • NPI 1700108776
  NPD (past)

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

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343952000000",
    "number": "1598083909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7592 METROPOLITAN DR",
            "address_2": "STE 400",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084428",
            "telephone_number": "877-727-5974",
            "fax_number": "877-728-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7592 METROPOLITAN DR",
            "address_2": "STE 400",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084428",
            "telephone_number": "877-727-5974",
            "fax_number": "877-728-3404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "AUTUMN",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-10",
        "last_updated": "2012-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY22939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Phillips
• Adelle Grace Phillips
• Allysia Phillips
• Alma Esteves Phillips, LCSW
• Arthur Phillips, M.D.
• Casey Phillips, DIMM
• Charese Amille Phillips
• Charles Clayton Phillips III, D.M.D.
• Cheryl-Anne Maria Phillips, AODS COUNSELOR
• Christopher Ryan Phillips, MD

• Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2012; 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.