Phillips Family Healthcare, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A003572 Issued in AR

Legal business name

PHILLIPS FAMILY HEALTHCARE, LLC

Practice address

2921 Hwy 77 S
Suites 12-13
Marion, AR 72364-2367

Phone

(901) 438-8451

NPI assigned

May 28, 2015

Last updated

May 28, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ted Phillips, APRN

Title

Owner/Practitioner

Phone

(901) 438-8451

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Phillips Family Healthcare LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Phillips Family Healthcare, LLC

  • Family Nurse Practitioner
  • Marked Tree, AR
  • NPI 1669319489
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Phillips Family Healthcare, LLC

  • Family Nurse Practitioner
  • Marked Tree, AR
  • NPI 1669319489
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Teddy Phillips, FNP-BC

  • Family Nurse Practitioner
  • Marion, AR
  • NPI 1043527336
  Medicare reassignment

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432771200000",
    "number": "1629457254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 HWY 77 S",
            "address_2": "SUITES 12-13",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723642367",
            "telephone_number": "901-438-8451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 HWY 77 S",
            "address_2": "SUITES 12-13",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723642367",
            "telephone_number": "901-438-8451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIPS FAMILY HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-28",
        "last_updated": "2015-05-28",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "TED",
        "authorized_official_title_or_position": "OWNER/PRACTITIONER",
        "authorized_official_telephone_number": "901-438-8451",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A003572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER'S NPI NUMBER",
            "identifier": "1043527336",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043527336",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelby Lynn Patterson
• Pearl Hospice Care LLC (River Valley Hospice)
• Barbara Pearson, MHPP
• Pediatric Associates of W MPHS
• Ashley Pham, PHARMD
• Robin Lynne Phillips, APRN, FNP-C
• Shanquita Shantrelle Phillips, AT
• Teddy Phillips, FNP-BC
• Thomas Ralph Pierce, DDS
• Marqual Levar Pitchford

• Family Nurse Practitioner in Marion, AR
• Providers in Marion, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.