Active NPI
Chance Leroy Phillips, NP-C
- Family Nurse Practitioner
- Tulsa, OK
National Provider Identifier
1740788595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 115935
- Practice address
- 4564 S Harvard Ave Ste B
Tulsa, OK 74135-2918 - Phone
- (918) 508-2220
- NPI assigned
- Jan 26, 2018
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 115935 | OK | Primary |
Addresses
Primary practice location
4564 S Harvard Ave Ste B
Tulsa, OK 74135-2918
Mailing address
2706 E 39TH PL
Tulsa, OK 74105-8209
Phone (806) 886-0062
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115935 | OK | MD | Family Nurse Practitioner |
Interoperability endpoints
- chance.phillips@250615391387652.direct.elationemr.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621296000000",
"number": "1740788595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2706 E 39TH PL",
"city": "TULSA",
"state": "OK",
"postal_code": "741058209",
"telephone_number": "806-886-0062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4564 S HARVARD AVE STE B",
"city": "TULSA",
"state": "OK",
"postal_code": "741352918",
"telephone_number": "918-508-2220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "CHANCE",
"middle_name": "LEROY",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-26",
"last_updated": "2021-05-18",
"certification_date": "2021-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OK",
"license": "115935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.