Dolores E Phillips

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1121 E Main Street
7TH Floor
Trotwood, OH 45426-4542

Phone

(937) 854-0210

NPI assigned

Jan 19, 2021

Sex

Female

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1679163257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 E MAIN ST FL 7",
            "city": "TROTWOOD",
            "state": "OH",
            "postal_code": "454262411",
            "telephone_number": "937-854-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 E MAIN STREET",
            "address_2": "7TH FLOOR",
            "city": "TROTWOOD",
            "state": "OH",
            "postal_code": "454264542",
            "telephone_number": "937-854-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "DOLORES",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-19",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326012360",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derrick Parks, QMHS
• Christopher Eric Pearson
• Jonista M. Peebles
• Tracey N Pettit, LPN
• Monique Nicole Pezant
• Breanna Danielle Pogue
• Michelle Potter, RN
• Natasha Preston
• Alicia Price
• Tavarae D Priest, LPN

• Behavior Technician in Trotwood, OH
• Providers in Trotwood, OH by specialty
• Behavior Technician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.