Jessica Krystal Phillips

Primary specialty

SpecialistTaxonomy code 174400000X

License

1551552211 Issued in NY

Practice address

6143 186TH St
Fresh Meadows, NY 11365-2710

Phone

(516) 835-9212

NPI assigned

Jul 12, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1689308017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 E 43RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112033026",
            "telephone_number": "347-407-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6143 186TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113652710",
            "telephone_number": "516-835-9212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JESSICA",
        "middle_name": "KRYSTAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "1551552211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betsy Petrocelli, P.A.
• Angela Petroutsos, MPT, DPT, CLT
• Peyman Younesi MD PLLC
• Philippians Staffing Services Inc
• Phillips Mental Health Counseling, P.C
• Lynda Phillips, LCMHC, NCC
• Dennis Piana, D.D.S
• Catherine Piccione, PH.D.
• Betty Pierre-Buly, REGISTERED NURSE
• Nara Ilyas Pink, RN

• Specialist in Fresh Meadows, NY
• Providers in Fresh Meadows, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; 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.