Active NPI
Hance Phillips
- Otolaryngology Physician
- Rockledge, FL
National Provider Identifier
1811979412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- ME18361
- Practice address
- 1099 Florida Ave S
Rockledge, FL 32955-2138 - Phone
- (321) 632-6900
- Fax
- (321) 639-7222
- NPI assigned
- Nov 18, 2005
- 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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | ME18361 | FL | Primary |
Addresses
Primary practice location
1099 Florida Ave S
Rockledge, FL 32955-2138
Mailing address
5590 Fraley CT
Merritt Island, FL 32953-7315
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 057173300 | Medicaid | FL |
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
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270598400000",
"number": "1811979412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5590 FRALEY CT",
"city": "MERRITT ISLAND",
"state": "FL",
"postal_code": "329537315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1099 FLORIDA AVE S",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329552138",
"telephone_number": "321-632-6900",
"fax_number": "321-639-7222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "HANCE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-18",
"last_updated": "2010-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "FL",
"license": "ME18361",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "057173300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockledge, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.