NPIMap

Individual provider Active NPI

Phillip Charles Teague, MD

  • Family Medicine Physician
  • Sugarcreek, OH
National Provider Identifier
1770571069
Registry record updated Oct 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35058831 Issued in OH
Practice address
126 1/2 N Broadway St
Sugarcreek, OH 44681-9384
Phone
(330) 852-3211
Fax
(330) 852-4018
NPI assigned
Oct 11, 2005
Last updated
Oct 29, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35058831 OH Primary

Addresses

Primary practice location

126 1/2 N Broadway St
Sugarcreek, OH 44681-9384

Mailing address

PO Box 218
Sugarcreek, OH 44681-0218
Phone (330) 852-3211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20070320000093 OH Practitioner - Family Practice 2062515604 Receives reassigned benefits from 3 practitioners
Practice locations: Sugarcreek, OH

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Northeastern Ohio University College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

153 /2 N Broadway
Sugarcreek, OH 44681
Phone (330) 852-3211

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35058831OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Altercare Coshocton, Inc. Past Accepting new patients
FHS Oakpointe, Inc. Past Accepting new patients
Be Well Pediatrics Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Oakpointe Nursing & RehabilitationBaltic, OH, CCN 366254 Skilled nursing facility Adp of the SNF Jun 1, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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.

Hospital & facility affiliations 10

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": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288310400000",
    "number": "1770571069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 218",
            "city": "SUGARCREEK",
            "state": "OH",
            "postal_code": "446810218",
            "telephone_number": "330-852-3211",
            "fax_number": "330-852-4018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 1/2 N BROADWAY ST",
            "city": "SUGARCREEK",
            "state": "OH",
            "postal_code": "446819384",
            "telephone_number": "330-852-3211",
            "fax_number": "330-852-4018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEAGUE",
        "first_name": "PHILLIP",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2010-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35058831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugarcreek, OH

Sources for this page

Verify at the official NPI Registry.