Demario Phillips

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1755 The Exchange SE
Suite 138
Atlanta, GA 30339-7400

Phone

(678) 612-4093

NPI assigned

Feb 19, 2013

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Practice roles

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.

• Leap of Faith Community Outreach LLC

  • Community/Behavioral Health Agency
  • Atlanta, GA
  • NPI 1659611499
  NPD (past) Authorized official

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

{
    "created_epoch": "1361232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1871833434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1458 INDIAN FOREST CT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300835436",
            "telephone_number": "678-612-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 THE EXCHANGE SE",
            "address_2": "SUITE 138",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303397400",
            "telephone_number": "678-612-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "DEMARIO",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-19",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brad Clinton Phillips, D.V.M.
• Brittany Phillips
• Crystal Phillips, M.S., BCBA
• Darnell Phillips, MS, L.P.C
• David Wayne Phillips, PH.D.
• Denia M Phillips, PT
• Donald Marvin Phillips Jr., DMD
• Gail Allison Phillips, LCSW
• Garneda Davonia Phillips, PAAA
• George Phillips, D.M.D.

• Counselor in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.