Stephen A Phillips, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01028159 Issued in IN

Practice address

1809 S Main St
Upland, IN 46989-9242

Phone

(765) 998-6200

Fax

(765) 998-6204

NPI assigned

Jun 6, 2006

Last updated

Dec 24, 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 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Indiana University Health Ball Memorial Physicians, Inc.

  • Family Medicine Physician
  • Muncie, IN
  • NPI 1235455544
  Medicare reassignment NPD
• Indiana University Health Ball Memorial Physicians, Inc

  dba IU Health Ball Memorial Family Medicine Clinic

  • Family Medicine Physician
  • Muncie, IN
  • NPI 1609800689
  NPD
• Saint Joseph Regional Medical Center, Inc.

  dba Saint Joseph Medical Group

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1467406074
  NPD (past)

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356307200000",
    "number": "1669411245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 N CELIA AVE",
            "address_2": "ATTN: DEBERA BARKER RCS",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473034609",
            "telephone_number": "765-282-8905",
            "fax_number": "317-968-1047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 S MAIN ST",
            "city": "UPLAND",
            "state": "IN",
            "postal_code": "469899242",
            "telephone_number": "765-998-6200",
            "fax_number": "765-998-6204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "STEPHEN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2012-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01028159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100173540",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01071459",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heidi M Lakanen, MD
• Jeffrey Wayne Marsee, LAT, ATC, DHED
• Midwest Healthstrategies, Inc
• Midwest Healthstrategies, Inc. (MWHS Occupational Medicine - Upland)
• Jenny Norton Schamber, PHD
• Susan Marie Ralston, RPH
• Patience Ramsey
• Usha Thapa, MD
• The Health and Hospital Corporation of Marion County (University Nursing Center)
• Troy Frederick Tiberi, MA

• Family Medicine Physician in Upland, IN
• Providers in Upland, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.