Phillip Blevins, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

07405 Issued in MS

Practice address

2500 N State St
Jackson, MS 39216-4500

Phone

(601) 984-5180

Fax

(601) 984-5183

NPI assigned

Jul 3, 2006

Last updated

Jun 13, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Plastic & Hand Surgery Associates PLLC

  • Plastic Surgery Physician
  • Flowood, MS
  • NPI 1932126695
  NPD (past)
• University Radiation Oncology Consultants, PLLC

  • Radiation Oncology Physician
  • Jackson, MS
  • NPI 1316026818
  NPD (past)

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1619907045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24146",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392254146",
            "telephone_number": "601-984-5180",
            "fax_number": "601-984-5183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5180",
            "fax_number": "601-984-5183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEVINS",
        "first_name": "PHILLIP",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MS",
            "license": "07405",
            "primary": true
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "MS",
            "license": "07405",
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "MS",
            "license": "07405",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00012332",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kailin Danielle Blanton, MD
• Betty Ann Blasi, FNP
• Blessings Beyond (Allied Home Care)
• Blessings Beyond (Allied Home Care)
• Wendy Nicole Blethen, NNP-BC
• Tasha Blevins, PCMHT
• Lauren Smythe Bloodworth, PHARM.D.
• Bloom Health Services for Women
• Philip J Blount, M.D.
• Blue Skyz Still Waters

• Plastic Surgery Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Plastic Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; 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.