Individual provider Active NPI

Philip Talley, FNP

  • Family Nurse Practitioner
  • Midland, TX
National Provider Identifier
1720402365
Registry record updated Jun 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP127457 Issued in TX
Practice address
4519 N Garfield St
Suite 6
Midland, TX 79705-3415
Phone
(432) 262-4528
Fax
(432) 201-7274
NPI assigned
Feb 18, 2014
Last updated
Jun 24, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP127457 TX Primary
Family Health Clinical Nurse Specialist 364SF0001X CNP-02359 NM

Addresses

Primary practice location

4519 N Garfield St
Suite 6
Midland, TX 79705-3415

Mailing address

4519 N Garfield St
Suite 6
Midland, TX 79705-3415
Phone (432) 262-4528

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP-02359NMMDFamily Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Care Center of Southlake, P.C. CurrentSince Apr 12, 2017 Accepting new patients
Silverlake Professional Group Current Accepting new patients

Locations

1500 W Southlake Blvd
Ste 120
Southlake, TX 76092
Phone (817) 416-6116

Organizations & group practices 3

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": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466726400000",
    "number": "1720402365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4519 N GARFIELD ST",
            "address_2": "SUITE 6",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797053415",
            "telephone_number": "432-262-4528",
            "fax_number": "432-201-7274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4519 N GARFIELD ST",
            "address_2": "SUITE 6",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797053415",
            "telephone_number": "432-262-4528",
            "fax_number": "432-201-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLEY",
        "first_name": "PHILIP",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-18",
        "last_updated": "2016-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP127457",
            "primary": true
        },
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "NM",
            "license": "CNP-02359",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.

Verify at the official NPI Registry.