Individual provider Active NPI

Keri V Phillips, RRA

  • Radiology Practitioner Assistant
  • Tupelo, MS
National Provider Identifier
1679386999
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Practitioner AssistantTaxonomy code 243U00000X
Practice address
830 S Gloster St
Tupelo, MS 38801-4934
Phone
(662) 377-5232
NPI assigned
Jan 30, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Practitioner Assistant 243U00000X Primary

Addresses

Primary practice location

830 S Gloster St
Tupelo, MS 38801-4934

Mailing address

806 County Road 683
Saltillo, MS 38866-6943
Phone (662) 213-2765

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

NPI Registry JSON

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

{
    "created_epoch": "1738195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1679386999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 COUNTY ROAD 683",
            "city": "SALTILLO",
            "state": "MS",
            "postal_code": "388666943",
            "telephone_number": "662-213-2765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014934",
            "telephone_number": "662-377-5232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "KERI",
        "middle_name": "V",
        "credential": "RRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-30",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "243U00000X",
            "taxonomy_group": "",
            "desc": "Radiology Practitioner Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.