Individual provider Active NPI

Sophia Philip, DNP

  • Pediatric Nurse Practitioner
  • Norcross, GA
National Provider Identifier
1720560626
Registry record updated Sep 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN158329 Issued in GA
Practice address
6010 Singleton Rd Ste 209
Norcross, GA 30093
Phone
(770) 248-0200
NPI assigned
Sep 6, 2018
Last updated
Sep 6, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN158329 GA
Pediatric Nurse Practitioner 363LP0200X RN158329 GA Primary

Addresses

Primary practice location

6010 Singleton Rd Ste 209
Norcross, GA 30093

Mailing address

1309 Nantahala TRL
Marietta, GA 30062-8804
Phone (770) 321-6071

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN158329GAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Peach Pediatrics LLC Past Accepting new patients
Choa Hospital Based, LLC Pediatrics Past Accepting new patients
Y. H. Parikh & Associates Past Accepting new patients

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": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536192000000",
    "number": "1720560626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 NANTAHALA TRL",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628804",
            "telephone_number": "770-321-6071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6010 SINGLETON RD STE 209",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "30093",
            "telephone_number": "770-248-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIP",
        "first_name": "SOPHIA",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-06",
        "last_updated": "2018-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN158329",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN158329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; 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.