Active NPI
Mary Johnson Phillips
- Case Management Agency
- Brooklyn, NY
National Provider Identifier
1699146266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Agency
- License
- 7631759
- Practice address
- 1117 Willoughby Ave
Apt. 3R
Brooklyn, NY 11237-2745 - Phone
- (917) 929-3755
- NPI assigned
- Oct 8, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | 7631759 | AL | Primary |
Addresses
Primary practice location
1117 Willoughby Ave
Apt. 3R
Brooklyn, NY 11237-2745
Mailing address
1117 Willoughby Ave
Apt. 3R
Brooklyn, NY 11237-2745
Phone (917) 929-3577
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7631759 | AL | MD | Case Management Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444262400000",
"number": "1699146266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1117 WILLOUGHBY AVE",
"address_2": "APT. 3R",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112372745",
"telephone_number": "917-929-3577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1117 WILLOUGHBY AVE",
"address_2": "APT. 3R",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112372745",
"telephone_number": "917-929-3755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "MARY JOHNSON",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-08",
"last_updated": "2015-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "AL",
"license": "7631759",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.