Organization Active NPI

Scott B Phillips PLLC

  • Multi-Specialty Clinic/Center
  • Wichita Falls, TX
National Provider Identifier
1669983201
Registry record updated Dec 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
SCOTT B PHILLIPS PLLC
Practice address
1912 Loop 11
Wichita Falls, TX 76306-4921
Phone
(940) 263-1551
Fax
(833) 620-2407
NPI assigned
Oct 23, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2023

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

Authorized official

Name
Dr. Scott B Phillips, MDNPI 1104035781
Title
President
Phone
(940) 263-1551

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1912 Loop 11
Wichita Falls, TX 76306-4921

Mailing address

1912 Loop 11
Wichita Falls, TX 76306-4921
Phone (940) 263-1551

Other names 1

  • Excelsis Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171128003009 TX Part B Supplier - Clinic/Group Practice 3971860016 Receives reassigned benefits from 1 practitioner
Practice locations: Henrietta, TX; Jacksboro, TX; Vernon, TX; Wichita Falls, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701475200000",
    "number": "1669983201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 LOOP 11",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763064921",
            "telephone_number": "940-263-1551",
            "fax_number": "833-620-2407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 LOOP 11",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763064921",
            "telephone_number": "940-263-1551",
            "fax_number": "833-620-2407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT B PHILLIPS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-23",
        "last_updated": "2023-12-02",
        "certification_date": "2023-12-02",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "940-263-1551",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excelsis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2023; 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.

Verify at the official NPI Registry.