Mary E Phillips, APN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

14012 Issued in TN

Practice address

105 1/2 Mathis Dr
Suite D
Dickson, TN 37055-2096

Phone

(615) 446-3061

Fax

(615) 446-9567

NPI assigned

Feb 24, 2009

Last updated

Feb 24, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shrinkty Medical Services, LLC

  dba Shrinkty

  • Substance Abuse Rehabilitation Facility
  • Murfreesboro, TN
  • NPI 1568190890
  Medicare reassignment
• Mental Health Cooperative, Inc

  dba Mental Health Cooperative

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Nashville, TN
  • NPI 1083632897
  NPD (past)

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

{
    "created_epoch": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235433600000",
    "number": "1609016005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 CUMBERLAND BND",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372281805",
            "telephone_number": "615-726-3340",
            "fax_number": "615-726-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 1/2 MATHIS DR",
            "address_2": "SUITE D",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552096",
            "telephone_number": "615-446-3061",
            "fax_number": "615-446-9567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-24",
        "last_updated": "2009-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "14012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Lee Petty, COTA/L
• Ashley Petty, LCSW
• William Russell Pevahouse, DPH
• Terica Denise Peyton
• Melinda L Phillips Freeman, APN
• Physiotherapy Associates Inc (Physiotherapy Associates)
• Cameron Steven Piechota, DPT
• David H Pierce, DPH
• Katharine Emma Pierce, MS-CCC-SLP
• Pinewood Medical LLC

• Psychiatric/Mental Health Nurse Practitioner in Dickson, TN
• Providers in Dickson, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.