Individual provider Active NPI

Thomas Phillips, MD

  • Obstetrics & Gynecology Physician
  • Florence, SC
National Provider Identifier
1649230343
Registry record updated Jan 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
7331 Issued in SC
Practice address
1590 Freedom Blvd
Ste. B
Florence, SC 29505-6071
Phone
(843) 665-9581
Fax
(843) 669-6426
NPI assigned
Mar 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 7331 SC Primary

Addresses

Primary practice location

1590 Freedom Blvd
Ste. B
Florence, SC 29505-6071

Mailing address

947 S Irby St
Florence, SC 29501-5238
Phone (843) 665-9581

Other identifiers 6

IdentifierTypeStateIssuer
073315MedicaidNC
4255295OtherSCAETNA
470890494OtherSCSTANDARD TAX ID
073315MedicaidSC
E2755OtherSCMEDCOST
0700481OtherSCCAROLINA CARE PLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20050622000105 SC Practitioner - Obstetrics/Gynecology 1850336751

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7331SCMDPhysical Therapy Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Phillip & Coker OB-GYN LLC Obstetrics & Gynecology Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388966400000",
    "number": "1649230343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "947 S IRBY ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295015238",
            "telephone_number": "843-665-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 FREEDOM BLVD",
            "address_2": "STE. B",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056071",
            "telephone_number": "843-665-9581",
            "fax_number": "843-669-6426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-25",
        "last_updated": "2014-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "7331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "073315",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4255295",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STANDARD TAX ID",
            "identifier": "470890494",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "073315",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "E2755",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAROLINA CARE PLAN",
            "identifier": "0700481",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.