NPIMap

Individual provider Active NPI

Terry M Phillis Jr., MD

  • Urology Physician
  • Anniston, AL
National Provider Identifier
1750359030
Registry record updated Mar 24, 2010
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Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
21542 Issued in AL
Practice address
622 Leighton Ave
Anniston, AL 36207
Phone
(256) 237-6717
Fax
(256) 237-6717
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 21542 AL
Urology Physician 208800000X 21542 AL Primary

Addresses

Primary practice location

622 Leighton Ave
Anniston, AL 36207

Mailing address

PO Box 428
622 Leighton Ave
Anniston, AL 36207
Phone (256) 237-6717

Other identifiers 2

IdentifierTypeStateIssuer
051076321OtherALBLUE CROSS AND BLUE SHIEL
000076321MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100923001102 AL Practitioner - Urology 2769520253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Wright State University Boonshoft School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Health Care Authority of the City of AnnistonGroup PAC ID 3971408923, 41 clinicians

Practice addresses (Care Compare)

400 E 10TH St
Anniston, AL 36202-4716
Phone (256) 235-5860

Hospital & facility affiliations

  • Amedisys Home Health of Anniston Home health agency, Anniston, AL, CCN 017305
  • Northeast Alabama Regional Medical Center Hospital, Anniston, AL, CCN 010078

Merit-based Incentive Payment System (MIPS)

Final score
82.81 of 100Reported as individual
Quality
59.14
Promoting interoperability
88
Improvement activities
40
Cost
93.56

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection11
Removal of tissue1-10
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21542ALMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
The Health Care Authority of the City of Anniston CurrentSince Jan 1, 2012 Accepting new patients
Anniston Pathology Current Accepting new patients
Anniston Urological Associates, PC Specialist Current Accepting new patients
The Health Care Authority of the City of Anniston Current Accepting new patients
The Health Care Authority of the City of Anniston CurrentSince Jan 1, 2012 Accepting new patients
Regional Medical Center Board Past Accepting new patients

Locations

400 E 10th St
Anniston, AL 36207
Phone (256) 235-5121

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15682/brand/1/csg/1/fhir/r4
  • Direct secure messaging: terry.phillis.1@15682.direct.athenahealth.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1750359030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "address_2": "622 LEIGHTON AVE",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "36207",
            "telephone_number": "256-237-6717",
            "fax_number": "256-236-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 LEIGHTON AVE",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "36207",
            "telephone_number": "256-237-6717",
            "fax_number": "256-237-6717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIS",
        "first_name": "TERRY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "21542",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AL",
            "license": "21542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIEL",
            "identifier": "051076321",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000076321",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anniston, AL

Sources for this page

Verify at the official NPI Registry.