Individual provider Active NPI

Terri Phillips, CRNA

  • Certified Registered Nurse Anesthetist
  • Virginia Beach, VA
National Provider Identifier
1699783415
Registry record updated Jun 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
24076690 Issued in VA
Practice address
1060 First Colonial Rd
Virginia Beach, VA 23454-3002
Phone
(757) 395-8369
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 24076690 VA Primary

Addresses

Primary practice location

1060 First Colonial Rd
Virginia Beach, VA 23454-3002

Mailing address

134 Business Park Dr
Virginia Beach, VA 23462-6523
Phone (757) 473-0055

Other identifiers 1

IdentifierTypeStateIssuer
009559175MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111221000703 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7517133523 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
24076690VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Anesthesia, Inc CurrentSince Aug 18, 1997 Accepting new patients

Locations

600 Gresham Dr
Norfolk, VA 23507
Phone (757) 473-0055

1060 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 395-2323

134 Business Park Dr
Virginia Beach, VA 23462
Phone (757) 473-0044

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339632000000",
    "number": "1699783415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 BUSINESS PARK DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234626523",
            "telephone_number": "757-473-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 FIRST COLONIAL RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543002",
            "telephone_number": "757-395-8369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "TERRI",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2012-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "24076690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009559175",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.