Active NPI
Cleveland Phillips Jr.
- Preferred Provider Organization
- San Antonio, TX
National Provider Identifier
1700438827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Preferred Provider Organization
- Practice address
- 11146 Vance Jackson Rd Apt 3801
San Antonio, TX 78230-2563 - Phone
- (210) 332-5408
- NPI assigned
- Jul 9, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Preferred Provider Organization | 305R00000X | Primary |
Addresses
Primary practice location
11146 Vance Jackson Rd Apt 3801
San Antonio, TX 78230-2563
Mailing address
11146 Vance Jackson Rd Apt 3801
San Antonio, TX 78230-2563
Phone (210) 332-5408
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562630400000",
"number": "1700438827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11146 VANCE JACKSON RD APT 3801",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782302563",
"telephone_number": "210-332-5408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11146 VANCE JACKSON RD APT 3801",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782302563",
"telephone_number": "210-332-5408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "CLEVELAND",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-07-09",
"last_updated": "2019-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "305R00000X",
"taxonomy_group": "",
"desc": "Preferred Provider Organization",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.