Heidi Suzanne Phillips, MSN APRN CNM IBCLC

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

202104538NP-PP Issued in OR

Practice address

1406 Marine Dr
Astoria, OR 97103-3808

Phone

(503) 468-0650

Fax

(503) 376-6716

NPI assigned

Apr 6, 2020

Last updated

Jun 3, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife, Master of Science - Nursing

State licenses

Practice roles

Locations

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.

• St Mary's Hospital and Medical Center, Inc

  • Hematology & Oncology Physician
  • Grand Junction, CO
  • NPI 1275714081
  Medicare reassignment NPD
• St Mary's Hospital and Medical Center, Inc

  dba St Mary's Anticoagulation Clinic

  • General Acute Care Hospital
  • Grand Junction, CO
  • NPI 1619742806
  NPD
• St Mary's Hospital and Medical Center, Inc

  dba St Mary's Regional Hospital Integrated Addiction Medicine

  • Addiction Medicine (Family Medicine) Physician
  • Grand Junction, CO
  • NPI 1649820481
  NPD

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1720617236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 MARINE DR",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033808",
            "telephone_number": "503-468-0650",
            "fax_number": "503-376-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 MARINE DR",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033808",
            "telephone_number": "503-468-0650",
            "fax_number": "503-376-6716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2241 N 7th St",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815017423",
            "country_code": "US",
            "telephone_number": "970-549-1711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "HEIDI",
        "middle_name": "SUZANNE",
        "credential": "MSN APRN CNM IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-06",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CO",
            "license": "APN.0995468-CNM",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OR",
            "license": "202104538NP-PP",
            "primary": true
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "CO",
            "license": "L-165889",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Pendergast, LMT
• Vishesh Anand Persaud, M.D
• Henry Perschek, LPC
• Makayla Ann Phillips-Koch, CCC-SLP
• Evan Duane Phillips
• Marcy P. Phillips, LPC
• Zachary McKee Phillips, M.D.
• Rachel Pinci
• Patience J. Pine, MD
• Skyler Marie Pink

• Advanced Practice Midwife in Astoria, OR
• Providers in Astoria, OR by specialty
• Advanced Practice Midwife in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.