Maryanne Deforest Phillips, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

7635 Issued in NV

Practice address

5052 Jones Blvd
135
Las Vegas, NV 89118

Phone

(702) 822-1881

Fax

(702) 822-1880

NPI assigned

Jul 28, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19187/brand/2/csg/1/fhir/r4

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.

• MPMD Anesthesiology Services LLC

  • Anesthesiology Physician
  • Las Vegas, NV
  • NPI 1801434535
  NPD (past) Authorized official
• Comprehensive Urgent Care

  • Urgent Care Clinic/Center
  • Las Vegas, NV
  • NPI 1578478673
  NPD (past)
• John T Goodsell DO PC Gregory Linderer MD LTD

  • Anesthesiology Physician
  • Henderson, NV
  • NPI 1427000413
  NPD (past)
• American Hospital Management Corporation

  • Rural Health Clinic/Center
  • Arcata, CA
  • NPI 1609979707
  NPD (past)
• Anesthesia Partners of North Valley

  • Anesthesiology Physician
  • Lancaster, CA
  • NPI 1639104144
  NPD (past)
• Roland D Reinhart M D a Professional Corporation

  • Pain Medicine Physician
  • Palm Desert, CA
  • NPI 1285615955
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334275200000",
    "number": "1780698456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10620 SOUTHERN HIGHLANDS PKWY",
            "address_2": "110-250",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891414369",
            "telephone_number": "702-822-1881",
            "fax_number": "702-822-1880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5052 JONES BLVD",
            "address_2": "135",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89118",
            "telephone_number": "702-822-1881",
            "fax_number": "702-822-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MARYANNE",
        "middle_name": "DEFOREST",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2012-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NV",
            "license": "7635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A637530",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A637530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John William Phillips III
• Kaitlyn Sandra Phillips
• Khristal Charmaine Andrea Phillips
• Latonda Phillips
• Lou Tanga Denise Phillips
• Michelle R Phillips
• Morgan Phillips
• Naraya Latrece Phillips
• Nathaniel Phillips Jr.
• Nicole Renee Phillips, APRN, AGPCNP-BC

• Specialist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Specialist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.