Active NPI
Phillip Hunter
- Psychologist
- Saint Clair Shores, MI
National Provider Identifier
1669853131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301016094
- Practice address
- 23600 Harper Ave
Saint Clair Shores, MI 48080-1445 - Phone
- (586) 200-5606
- NPI assigned
- Jun 10, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301016094 | MI | Primary |
Addresses
Primary practice location
23600 Harper Ave
Saint Clair Shores, MI 48080-1445
Mailing address
45546 Hampshire St
Macomb, MI 48044-3844
Phone (586) 850-6854
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150723009647 | MI | Practitioner - Psychologist Billing Independently | 1355654039 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairsky Foundation | Psychologist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433894400000",
"number": "1669853131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45546 HAMPSHIRE ST",
"city": "MACOMB",
"state": "MI",
"postal_code": "480443844",
"telephone_number": "586-850-6854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23600 HARPER AVE",
"city": "SAINT CLAIR SHORES",
"state": "MI",
"postal_code": "480801445",
"telephone_number": "586-200-5606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUNTER",
"first_name": "PHILLIP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-10",
"last_updated": "2015-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301016094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Clair Shores, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.