Individual provider Active NPI

Danielle S Phillip-Journal, MD

  • Internal Medicine Physician
  • Danbury, CT
National Provider Identifier
1609282219
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
56757 Issued in CT
Practice address
100 Reserve Rd Ste A4
Danbury, CT 06810-5267
Phone
(203) 794-1979
NPI assigned
Jul 2, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 56757 CT Primary

Addresses

Primary practice location

100 Reserve Rd Ste A4
Danbury, CT 06810-5267

Mailing address

100 Reserve Rd Ste A4
Danbury, CT 06810-5267
Phone (203) 794-1979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170825000981 CT Practitioner - Internal Medicine 3779880554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prohealth Physicians PCGroup PAC ID 1355246950, 214 clinicians

Practice addresses (Care Compare)

100 Reserve Rd
Suite A4
Danbury, CT 06810-5267
Phone (203) 794-1979

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
56757CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Physicians PC Internal Medicine CurrentSince Jan 9, 2023 Accepting new patients

Locations

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

Interoperability endpoints

  • Direct secure messaging: danielle.phillip-journal.npi1609282219.phpct@direct.optumcare.masshiway.net

Organizations & group practices 1

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1609282219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RESERVE RD STE A4",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105267",
            "telephone_number": "203-794-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RESERVE RD STE A4",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105267",
            "telephone_number": "203-794-1979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIP-JOURNAL",
        "first_name": "DANIELLE",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-02",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "56757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.