Danial Ray Phipps Jr.

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

31764 Casino Dr Ste 200
Lake Elsinore, CA 92530-2312

Phone

(951) 471-4649

NPI assigned

Apr 21, 2021

Sex

Male

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

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1699357541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31764 CASINO DR STE 200",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925302312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31764 CASINO DR STE 200",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925302312",
            "telephone_number": "951-471-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHIPPS",
        "first_name": "DANIAL",
        "middle_name": "RAY",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew T Pham, D.C.
• Jimmy Ninh Hoang Phan, M.D.
• Phillip Rechister
• Alyssa Phillipe, M.A., BCBA
• Mark G Phillipe, DDS
• Anh-Hoa Phung
• Physician RX MGMT Inc.
• Brianna Pike
• Gabrielle Whitney Pinchem
• Brittany Fallon Pinheiro

• Peer Specialist in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.