Phoenix Medical Practice Corporation S C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036059274 Issued in IL

Legal business name

PHOENIX MEDICAL PRACTICE CORPORATION S C

Practice address

5727 Strathmoor Dr
Rockford, IL 61107-5180

Phone

(815) 226-8050

NPI assigned

Feb 15, 2012

Last updated

Feb 24, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James W Phoenix

Title

President

Phone

(815) 226-8050

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330041600000",
    "number": "1740553155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5727 STRATHMOOR DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075180",
            "telephone_number": "815-226-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5727 STRATHMOOR DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075180",
            "telephone_number": "815-226-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX MEDICAL PRACTICE CORPORATION S C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-15",
        "last_updated": "2012-02-24",
        "status": "A",
        "authorized_official_last_name": "PHOENIX",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-226-8050",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036059274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenden Tyler Phelps
• Jamie E Phelps, ATC
• Jillian Marie Phelps, O.D.
• Ashley Phillips, LCSW
• Phoenix Counseling and Recovery LLC
• Sirivanh Phomvansi Gamez, P.T.
• Physician Associates Limited (D/B/A Cherry Valley Medical Clinic)
• Physicians Care Network, Inc.
• Physicians Immediate Care LTD
• Stephen William Pichler, M.D.

• Family Medicine Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; 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.