Susan M Phillips, M.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301052812 Issued in MI

Practice address

2249 Wealthy St SE
Ste 110
East Grand Rapids, MI 49506-3052

Phone

(616) 391-4600

Fax

(616) 486-0133

NPI assigned

Jun 10, 2005

Last updated

Jul 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1841294410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2249 WEALTHY ST SE",
            "address_2": "STE 110",
            "city": "EAST GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495063052",
            "telephone_number": "616-391-4600",
            "fax_number": "616-486-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2249 WEALTHY ST SE",
            "address_2": "STE 110",
            "city": "EAST GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495063052",
            "telephone_number": "616-391-4600",
            "fax_number": "616-486-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-10",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301052812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie Wilson, LLC (Marie J Wilson, LMSW)
• Sandra Michelle Miles-Rolo, PT
• Miriam Lorrain PLLC
• Jessika Perez
• Brian V Phillips, MD
• Physiotherapy Associates Inc
• Amy S Pouillon, PHARMD
• Charles Przybylo
• Anna Reeve
• Restore Therapy Collective (Jen Hutchings, Ph.D, LMFT)

• Family Medicine Physician in East Grand Rapids, MI
• Providers in East Grand Rapids, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; 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.