Active NPI
Dennis B Phillips, DO
- Occupational Medicine Physician
- Manitowoc, WI
National Provider Identifier
1710011291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Physician
- License
- 34116
- Practice address
- 601 Reed Ave
Manitowoc, WI 54220-2026 - Phone
- (920) 793-7300
- NPI assigned
- Mar 15, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Medicine Physician | 2083X0100X | 34116 | WI | Primary |
Addresses
Primary practice location
601 Reed Ave
Manitowoc, WI 54220-2026
Mailing address
526 Saint Clair Ave
Sheboygan, WI 53081-3528
Phone (920) 457-0318
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34116 | WI | MD | Occupational Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476057600000",
"number": "1710011291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "526 SAINT CLAIR AVE",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530813528",
"telephone_number": "920-457-0318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 REED AVE",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542202026",
"telephone_number": "920-793-7300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "DENNIS",
"middle_name": "B",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-15",
"last_updated": "2016-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "WI",
"license": "34116",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manitowoc, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.