Individual provider Active NPI

Steven Robert Phillips, DO

  • Psychiatry Physician
  • Charlottesville, VA
National Provider Identifier
1679990568
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0102205265 Issued in VA
Practice address
325 Four Leaf LN Ste 12
Charlottesville, VA 22903-9203
Phone
(434) 466-1588
Fax
(434) 823-1174
NPI assigned
Mar 28, 2014
Last updated
Oct 10, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 0102205265 VA Primary

Addresses

Primary practice location

325 Four Leaf LN Ste 12
Charlottesville, VA 22903-9203

Mailing address

220 Appalachian LN
Zion Crossroads, VA 22942-7021
Phone (804) 815-0590

Other practice location 1

800 Preston Ave
Charlottesville, VA 22903-4420
Phone (434) 972-1800

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102205265VAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1679990568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 APPALACHIAN LN",
            "city": "ZION CROSSROADS",
            "state": "VA",
            "postal_code": "229427021",
            "telephone_number": "804-815-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 FOUR LEAF LN STE 12",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229039203",
            "telephone_number": "434-466-1588",
            "fax_number": "434-823-1174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Preston Ave",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229034420",
            "country_code": "US",
            "telephone_number": "434-972-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "STEVEN",
        "middle_name": "ROBERT",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-28",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0102205265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.