Active NPI
Russell Phillips, D.O.
- Family Medicine Physician
- Coppell, TX
National Provider Identifier
1629041827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- J0197
- Practice address
- 171 N Denton Tap Rd
#200
Coppell, TX 75019-2915 - Phone
- (972) 745-4446
- Fax
- (972) 745-2597
- NPI assigned
- Feb 8, 2006
- Last updated
- Sep 18, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | J0197 | TX | Primary |
Addresses
Primary practice location
171 N Denton Tap Rd
#200
Coppell, TX 75019-2915
Mailing address
171 N Denton Tap Rd
#200
Coppell, TX 75019-2915
Phone (972) 745-4446
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| J0197 | TX | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Urologic Surgery LLC | Past | Accepting new patients | |
| Primamed Physicians PLLC | Past | Accepting new patients | |
| PTW Health, PLLC | Family Medicine | Past | Accepting new patients |
| Primamed Physicians PLLC | Past | Accepting new patients |
Interoperability endpoints
- russell.phillips@4097.securemail.prognocis.com
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Coppell, TX
- NPI 1346576949
-
dba Baylor Scott & White Urgent Care Plus
- Urgent Care Clinic/Center
- Dallas, TX
- NPI 1164494068
-
dba Baylor Scott & White Urgent Care Plus
- Urgent Care Clinic/Center
- Plano, TX
- NPI 1619922549
-
dba Path to Wellness Chiropractic & Integrated Health
- Internal Medicine Physician
- Fort Worth, TX
- NPI 1427698901
Family Medicine
-
- Ambulatory Surgical Clinic/Center
- Saint Louis, MO
- NPI 1093230450
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253232000000",
"number": "1629041827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "171 N DENTON TAP RD",
"address_2": "#200",
"city": "COPPELL",
"state": "TX",
"postal_code": "750192915",
"telephone_number": "972-745-4446",
"fax_number": "972-745-2597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "171 N DENTON TAP RD",
"address_2": "#200",
"city": "COPPELL",
"state": "TX",
"postal_code": "750192915",
"telephone_number": "972-745-4446",
"fax_number": "972-745-2597"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "RUSSELL",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-08",
"last_updated": "2009-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "J0197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coppell, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.