Individual provider Active NPI

Brandi Phillips, RN

  • General Practice Registered Nurse
  • Boulder Creek, CA
National Provider Identifier
1679368328
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
755096 Issued in CA
Practice address
15595 Forest Hill Dr
Boulder Creek, CA 95006-8623
Phone
(661) 889-5728
NPI assigned
Apr 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 755096 CA Primary

Addresses

Primary practice location

15595 Forest Hill Dr
Boulder Creek, CA 95006-8623

Mailing address

15595 Forest Hill Dr
Boulder Creek, CA 95006-8623
Phone (661) 889-5728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
755096CAMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1679368328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15595 FOREST HILL DR",
            "city": "BOULDER CREEK",
            "state": "CA",
            "postal_code": "950068623",
            "telephone_number": "661-889-5728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15595 FOREST HILL DR",
            "city": "BOULDER CREEK",
            "state": "CA",
            "postal_code": "950068623",
            "telephone_number": "661-889-5728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "BRANDI",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "755096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.